Proprioception Analysis following Anterior Cruciate Ligament Reconstruction using Stabilometry: A Prospective, Longitudinal Study / Análise de propriocepção por estabilometria após a reconstrução do ligamento cruzado anterior: Um estudo prospectivo e longitudinal

Abstract Objective Commonly used methods for measuring proprioception have resulted in conflicting reports regarding knee proprioception with anterior cruciate ligament (ACL) rupture and the influence of ACL reconstruction. Methods One hundred subjects (50 patients with radiologically and arthroscopically confirmed unilateral ACL rupture and 50 normal controls) were assessed with regards to proprioception using dynamic single-leg stance postural stabilometry. Instrumented knee ligament laxity and knee outcome scores were also measured. Of the 50 patients in the ACL group, 34 underwent reconstruction and were reassessed postoperatively. Results There was a significant proprioceptive deficiency in the ACL group compared with their contralateral knee ( p < 0.001) and to the control group ( p = 0.01). There was asignificant improvement in knee proprioception following ACL reconstruction compared to preoperative findings ( p = 0.003). There was no correlation between ligament laxity measurements and outcome scores. A significant correlation was found preoperatively between outcome scores and proprioception measurements. This correlation was not found post-operatively. Pre-operative proprioception testing had asignificant correlation (r = 0.46) with post-operative proprioception ( p = 0.006). Conclusion Patients with an ACL rupture had a proprioceptive deficit which improved following ligament reconstruction. Knee outcome scores had a better correlation with proprioception than ligament laxity. Proprioception may be a superior objective measure than ligament laxity in quantifying functional knee deficits and outcomes in patients with ACL ruptures. Level of Evidence III Therapeutic Study; Prospective Longitudinal Case-Control Study.

Resumo Objetivo Os métodos comumente usados para medir a propriocepção resultaram em relatos conflitantes sobre a propriocepção do joelho com ruptura do ligamento cruzado anterior (LCA) e a influência da reconstrução do LCA. Métodos A propriocepção de 100 indivíduos (50 pacientes com ruptura unilateral do LCA confirmada à radiologia e artroscopia e 50 controles normais) foi avaliada por estabilometria postural dinâmica em apoio unipodal. A lassidão ligamentar do joelho instrumentado e suas pontuações de desfechos também foram medidas. Dos 50 pacientes do grupo LCA, 34 foram submetidos à reconstrução e reavaliados no período pós-operatório. Resultados O grupo LCA apresentou deficiência proprioceptiva significativa em relaçãoaojoelho contralateral ( p < 0,001) e ao grupo controle ( p = 0,01). A propriocepção do joelho melhorou de maneira significativa após a reconstrução do LCA em relação aos achados pré-operatórios ( p = 0,003). Não houve correlação entre as medidas de lassidão ligamentar e as pontuações de desfechos. Além disso, observamos uma correlação significativa entre as pontuações de desfechos e as medidas de propriocepção antes da cirurgia. Essa correlação não foi detectada no período pós-operatório. O teste pré-operatório de propriocepção teve correlação significativa ( r = 0,46) com a propriocepção pós-operatória ( p = 0,006). Conclusão Os pacientes com ruptura do LCA apresentaram déficit proprioceptivo que melhorou após a reconstrução ligamentar. As pontuações de desfecho do joelho tiveram melhor correlação à propriocepção do que a lassidão ligamentar. A proprio-cepção pode ser uma medida objetiva superior à lassidão ligamentar na quantificação de déficits funcionais e desfechos do joelho em pacientes com ruptura do LCA. Nível de Evidência III Estudo Terapêutico; Estudo de Caso-Controle Longitudinal Prospectivo.

A 120-second stretch improves postural control and plantar pressure: quasi-experimental study

ABSTRACT BACKGROUND: There are no studies on long-term bilateral calf stretching in relation to balance and plantar pressure. OBJECTIVES: To demonstrate that there is better control of posture and pressures after continuous stretching of the posterior calf muscles. DESIGN AND SETTING: Pre and post-intervention study conducted in a private clinic. METHODS: We measured static footprints and stabilometry before and after continuous passive plantar flexor stretching of duration 120 seconds, among 24 healthy subjects. RESULTS: We found differences in Y displacement with eyes closed (P = 0.010), but not among other variables with eyes closed: X displacement (P = 0.263); surface (P = 0.940); laterolateral speed displacement (P = 0.279); and anteroposterior speed displacement (P = 0.914). There were also no differences in eyes-open variables: X displacement (P = 0.341); Y displacement (P = 0.491); surface (P = 0.167); laterolateral speed displacement (P = 0.852); and anteroposterior speed displacement (P = 0.079). The plantar pressures in the heel (maximum pressure, P = 0.048; mean pressure, P = 0.001) and in the midfoot (maximum pressure, P = 0.004; mean pressure, P = 0.004) were reduced, but not in the forefoot (maximum pressure, P = 0.391; mean pressure, P = 0.225). The surface became larger in the forefoot (P = 0.000) and midfoot (P = 0.021). CONCLUSIONS: Continuous static stretching of plantar flexors for 120 seconds improved stance balance and reduced plantar pressures (maximum and mean) in the rearfoot and midfoot. It also increased the surface in the midfoot and forefoot. TRIAL REGISTRATION: at clinicaltrials.gov, under the number NTC03743168.

Evaluating the effect of a water exercise routine on the postural stability of the elderly / Evaluación del efecto de una rutina de ejercicios acuáticos sobre la estabilidad postural de adultos mayores

Abstract Background: Postural stability enables humans to maintain the center of mass of their body within their base of support. Nevertheless, over time, such stability is affected by different factors such as age, repetitive strain, and accidents. Although studies in this field have investigated the effectiveness of hydrotherapy, only a few of them have explored its influence on postural stability, which is reflected in a lack of research that estimates its impact on rehabilitation. Aim: To determine the immediate and final effects of an aquatic routine protocol on the postural stability of elderly subjects. Methods: The postural stability of 20 adults over 60 years of age was analyzed using electromyographic and baropodometric methods. Electromyographic signals were obtained from the tibialis anterior, soleus, both gastrocnemius, vastus medialis, and biceps femoris to calculate the coactivation percentage of the muscles in charge of postural stability. The baropodometric data were collected to analyze the area of the stabilometric ellipse, mean plantar pressure, and weight distribution percentage. Results: The outcome of both methods revealed improvements in the elderly patients after the aquatic routine protocol was applied, which indicates that the type of water exercises implemented in this study has positive effects on their postural stability. Conclusion: The postural stability of the elderly participants was improved after each session because their stability index decreased along with the electrical activity of some muscle pairs, their body weight was better distributed, and the area of body oscillation was reduced. However, this effect was immediate and not final.

Resumen Antecedentes: La estabilidad postural permite a los humanos mantener el centro de masa de su cuerpo dentro de su base de apoyo. Sin embargo, con el tiempo, dicha estabilidad se ve afectada por diferentes factores como la edad, el esfuerzo repetitivo y los accidentes. Si bien los estudios en este campo han investigado la efectividad de la hidroterapia, solo algunos de ellos han explorado su influencia en la estabilidad postural, lo que se refleja en la falta de investigaciones que estimen su impacto en la rehabilitación. Objetivo: Determinar los efectos inmediatos y finales de un protocolo de rutina acuática sobre la estabilidad postural de adultos mayores. Métodos: Se analizó la estabilidad postural de 20 adultos mayores de 60 años mediante métodos electromiográficos y baropodométricos. Se obtuvieron señales electromiográficas del tibial anterior, sóleo, gastrocnemio, vasto interno y bíceps femoral para calcular el porcentaje de coactivación de los músculos encargados de la estabilidad postural. Los datos baropodométricos se recolectaron para analizar el área de la elipse estabilométrica, la presión plantar media y el porcentaje de distribución del peso corporal. Resultados: Ambos métodos mostraron mejoras en los pacientes luego de la aplicación del protocolo de rutina acuática, lo que indica que el tipo de ejercicios acuáticos implementados en este estudio tiene efectos positivos en su estabilidad postural. Conclusión: La estabilidad postural de los participantes mejoró después de cada sesión porque su índice de estabilidad disminuyó junto con la actividad eléctrica de algunos pares de músculos, su peso corporal se distribuyó mejor y se redujo el área de oscilación corporal. Sin embargo, este efecto fue inmediato y no definitivo.

A Partial Functional Restoration After Hallux Valgus Correct Surgery - A Controlled Preliminary Study

Introduction: Hallux valgus is the most common condition found in the foot, caused by a progressive failure of the first ray stabilization means. The hallux is deviated into valgus, the first metatarsal into varus, and their association leads to a subluxation of the metatarsophalangeal joint of the first ray. Surgery is a treatment frequently used to correct this condition. So, is the static postural balance altered after corrective surgery? Materials and Method: 23 subjects participated in the study, all women, divided into two groups: control and hallux valgus. The hallux valgus group was evaluated three months post-operatively. Bipodal tests were carried out on a stabilometry platform, one with eyes open and one with eyes closed. The pressure center parameters were recorded and analyzed, such as the length or the area of the pressure center. Results: The results obtained showed significant differences between the two groups and were statistically significant, with a p-value of 0,05. The pressure center values are higher in the hallux valgus group. Conclusion: Some results found in the literature agree with the results of the present study. There are significant deficits in the static postural balance three months after corrective surgery. Other studies with a larger sample may be performed to confirm or not the results of this study.

Influence Of Anterior Cruciate Ligament Surgery With Semitendinous And Gracilis Graft On Static Postural Balance At 3 Months Postoperatively: Randomized Controlled Study

Background: The anterior cruciate ligament (ACL) tear is the most common sports injury. Surgery is often proposed, but single-leg and double-leg static postural disorders have been discovered several months after surgery. Our aims are to compare postural disorders after ligament reconstruction by hamstring tendon graft in the three months after surgery to those caused by aging. Methods: 2 groups of subjects underwent bilateral and unilateral postural tests. An analysis of the center of pressure’s displacement is carried out for each test. Results: Comparison of the two groups shows no significant difference for the injured leg on the unilateral and bilateral tests only (p-value>0,05). Conclusion: Postural alteration after an ACL reconstruction on the injured leg and bilateral posture can be compared to postural disorders caused by age.

Stabilometric Assesment Of Postural Changes Induced By Spine Orthoses In A Geriatric Population

The use of spine orthoses in vertebral fractures of frailty in the adult-elderly population always poses problems of appropriate choice of the same as a function of the control of patients' balance. The vertebral fracture conjugated to the use of external devices modifying the posture can lead to negative effects, starting from the patient's poor compliance. The study of the equilibrium with dynamic platform represents a moment of validation of the appropriateness of the corset, even if temporarily carried. This has implications also for the rehabilitation of these patients after surgery.

Patrones biomecánicos de referencia para el diagnóstico temprano de trastornos del equilibrio: Estudio piloto / Biomechanical reference standards for early diagnosis of disturbances of balance: pilot study

Resumen: La inestabilidad de la postura y alteración del balance corporal son signos comúnmente observados en sujetos con afecciones que comprometen el sistema músculo-esquelético, visual, vestibular y propioceptivo, siendo la estabilometría la principal herramienta de valoración clínica. Sin embargo, no se ha podido establecer un gold standard o patrones cuantitativos que permitan clasificar sujetos sanos y patológicos basados en el grado de alteración del equilibrio. Objetivo: El objetivo principal de este estudio fue realizar un análisis estabilométrico preliminar con 38 sujetos sanos (19 mujeres y 19 hombres), con el fin de identificar un patrón de desplazamiento característico de la postura. Metodología: Este estudio se basó en la aplicación del test de Romberg. Se realizaron tres mediciones en cada paciente con ojos abiertos (OA) y ojos cerrados (OC), ubicados sobre una plataforma de fuerza en posición vertical. Resultado: se identificó un patrón característico de desplazamiento en los ejes medio-lateral X y antero-posterior Y, así como una estabilidad notable sobre el eje vertical Z, alrededor del centro de presión. Limitaciones: Sin embargo, debido al tamaño de la muestra, no se encontraron resultados concluyentes sobre las diferencias de índice de masa corporal, sexo o edad en el grupo de estudio. Originalidad: A pesar de ello, se encontraron parámetros prometedores para la evaluación de la estabilometría en personas jóvenes sanas, fortalenciendo con ellos las herramientas objetivas de valoración clínica. Conclusión: Esta investigación permitió identificar características de movimiento comunes para pacientes normales, que pueden ser consideradas como un patrón objetivo para el seguimiento y evaluación de tratamientos en pacientes con trastornos del equilibrio de origen patológico.

Abstract: The postur instability and body balance alteration, are signs commonly observed in patients with diseases associated with the musculoskeletal, visual, vestibular and proprioceptive systems, being the stabilometry the main clinical assessment study. However, it has not been established a standard or a quantitative pattern to classify healthy and pathological subjects based on the impaired balance level. Objective: The main objective of this study was to conduct a preliminary stabilometric analysis in 38 healthy subjects (19 women and 19 men) in order to identify a characteristic pattern of the position displacement. Methodology: This study was based on the Rombergś test. Three measurements was performed to each patient with open eyes (OA) and eyes closed (OC) stand over a force platform. Results: A characteristic pattern of the medio-lateral X and anteroposterior Y movement was identified, and remarkable stability on the vertical axis Z around the center of pressure. Limitations: However, because of the small sample size there was not found conclusive results related to Body-Mass-Index, sex or age. Originality: Despite, promising parameters were found for the evaluation of stabilometry in healthy young people, strengthening the objective tools of clinical assessment. Conclusion: This research identified common patient characteristics of normal movement, that could be considered as an objective standard for patient monitoring and treatment evaluation in patients with pathological balance disorders.

Interpretación de Variabilidad en la Postura Bípeda Quieta en edad Sensible al Sistema de Control / Interpretation of the variability of the steady bipedal posture in age sensitive to the system control

Resumen: El estudio del control postural humano mediante técnicas mecano-estadísticas, permite identificar comportamientos dinámicos con características de persistencia y anti-persistencia. Tales comportamientos, pueden ser interpretados como variabilidad tiempo dependiente en los sistemas de control y algunos indicadores que dan cuenta de éstos, son el coeficiente de difusión y el exponente de ajuste obtenidos con la técnica de Análisis de Difusión del Estabilograma (ADE). Se utilizó una plataforma de fuerza para los registros estabilométricos y se aplicó el ADE con el objeto de discriminar el comportamiento temporal de la variabilidad del centro de presión, en posición bípeda cuasi-estática con y sin restricción visual (Ojos cerrados y Ojos abiertos) en un grupo de 22 escolares en edad crítica (11,2±1,5 años) de maduración del proceso de control. Los resultados obtenidos en los coeficiente de difusión (Ds, DƖ) y exponentes de ajuste (Hs, HƖ ) en ambas condiciones visuales, caracterizan claramente comportamientos diferenciados para cada fases de la gráfica del ADE, y se establece diferencias significativas en los indicadores Ds y Hs, al comparar la excursión del COP con y sin restricción visual. El ADE nos permite identificar un comportamiento de sistema de control postural similar al de los adultos, modelado como un movimiento browniano fraccionario de dos fases.

Abstract: The human postural control study through statistical mechanic techniques identifies dynamic behavior with characteristics of persistence and anti-persistence. Such behaviors are interpreted like time-dependent variability of the control systems, and indicators that reflect these ones, are diffusion coefficient and scaling exponent obtained with stabilogram diffusion analysis (SDA) technique. A force platform was used to obtain stabilometry records and SDA was applied in order to discriminate the temporal behavior of the variability in quasi-static bipedal position in a group of 22 students in critical age (11,2 ± 1,5 years old) for postural control maturity, between eyes-closed and eyes-open conditions. The results of diffusion coefficients (Ds, DƖ ) and scaling exponents (Hs, HƖ ) in both visual condition have two distinct phases from ADE graphic and establish statistically significant differences for D s and H s, when comparing the displacement of COP between open eyes and closed eyes. The SDA allows us to identify a behavior of postural control system similar to adults, modeled like a two-phase fractional Brownian motion.

Association between age and dynamic balance capability assessed by use of force plates / 体力科学

This study aimed to evaluate dynamic balance capability, bathyesthesia, and the composite compensation of bathyesthesia and visual sense for dynamic balance assessed by use of force plates and to examine their correlation to age in a cross-sectorial manner. Participants of this study were 147 healthy people (55 men, 92 women). To evaluate dynamic balance capability, we evaluated the index of postural stability (IPS), which is the logarithmic value of the ratio of the area of stability limits to the area of postural sway, with participants standing on a hard surface with eyes opened. To measure bathyesthesia, we evaluated the modified index of postural stability (MIPS), i.e., the IPS with participants standing on a soft surface with eyes closed. As for the composite compensation index of bathyesthesia and visual sense for dynamic balance, we calculated the rubber IPS Romberg ratio (MIPS/IPS). The correlation coefficients (Spearman’s rho) of IPS, MIPS and MIPS/IPS to age were −0.666 (p < 0.001), −0.697 (p < 0.001) and −0.600 (p < 0.001), respectively. These results suggest that dynamic balance capability and bathyesthesia decline with advancing age, and the composite compensation of bathyesthesia and visual sense for dynamic balance strengthens with advancing age.

Comparação do equilíbrio postural unipodal entre crianças e adultos / Comparison of a single leg stance balance between children and adults

O objetivo do estudo foi comparar o equilíbrio na posição unipodal entre crianças com desenvolvimento típico de oito a 11 anos de idade e adultos saudáveis. Os participantes foram divididos em três grupos: 8-9 anos, 10-11 anos e 18-25 anos. Para medir o equilíbrio foi utilizada uma plataforma de força AccuSway Plus (AMTI Inc.). Cada sujeito realizou três tentativas com duração de 30 segundos em posição unipodal dominante. Os parâmetros avaliados foram: amplitude do centro de pressão nas direções ântero-posterior e médio-lateral, o comprimento total do trajeto, velocidade média e 95% da área da elipse. Para a análise estatística utilizou-se o SPSS versão 13.0 Foram realizados os teste de Shapiro-Wilk, Anova One-Way, Post Hoc de Bonferroni e correlação de Pearson. O nível de significância adotado foi p < 0,05. Os resultados mostraram que houve diferenças significativas (p < 0,01) entre os grupos de crianças e o grupo de adultos em todas as variáveis. Entre os grupos de crianças (8-9 anos e 10-11 anos) não houve diferença significativa em nenhuma das variáveis analisadas. Os resultados sugerem que crianças de oito a 11 anos de idade ainda não alcançaram a completa maturação do equilíbrio postural. Essas informações podem ser importantes para auxiliar em diagnósticos de transtornos ou déficits do equilíbrio, tanto em crianças como em adultos

The aim of this study was to compare postural balance in single leg stance between typically developing children aged 8 to 11 years old and healthy adults. The participants were divided into 3 groups: 8-9 years old, 10-11 years old and 18-30 years old. A force plate (AccuSway Plus, AMTI, Inc.) was used to measure the postural balance. Each subject performed three trials lasting 30 seconds in dominant single leg stance. The parameters recorded were: center of pressure amplitude the in the anteroposterior and mediolateral directions, total path length, average velocity and 95% of the ellipse area. SPSS (version 13.0) was used for statistical analysis. Shapiro-Wilk test, One-way Anova, Bonferroni post hoc and Pearson correlation were applied. The level of significance used was p < 0.05. The results showed significant differences (p < 0.01), between children and adult groups in all variables. Between groups of children (8-9 years and 10-11 years) there was no significant difference in any variables. The results suggest that children aged 08-11 years old have not reached complete maturation of postural balance. This information may be important to aid in the diagnosis of disorders or deficits of balance, both in children and in adults

Respostas estabilométrica de jovens e idosos para recuperar o equilíbrio após uma perturbação inesperada controlada / Stabilometric responses of young and elderly to recover balance after an unexpected controlled perturbation

A presente investigação teve como objetivo determinar as características empregadas durante a recuperação do equilíbrio decorrentes de uma perturbação inesperada entre idosos e adultos jovens. Para tanto, 20 jovens universitários (22 ± 2,6 anos; 62,3 ± 10,6 kg) e 20 idosos (70,3 ± 3,2 anos; 64,5 ± 9,3 kg) foram submetidos a um teste de perturbação do controle postural sobre uma plataforma de forças.A amplitude do CP na direção anteroposterior foi de 3,20 ± 0,67 cm para os jovens, que apresentaram um menor deslocamento do que os idosos (4,55 ± 0,9 cm; p<0,05). Verificou-se que os idosos apresentaram deslocamentos maiores e mais rápidos do centro de pressão na direção anteroposterior do que os adultos jovens. Esta maior amplitude de oscilação nos idosos provoca uma resposta mais lenta na recuperação da instabilidade, com isto aumentando a probabilidade de queda nesta população.

This research aimed to determine the characteristics employed during balance recovery arising from an unexpected disruption between elderly and young adults. Therefore, 20 university students (22 ± 2.6 anos; 62.3 ± 10.6 kg) and 20 elderly (70.3 ± 3.2 anos; 64.5 ± 9.3 kg) underwent a test disturbance of posture control on a force platform. The amplitude of the CP in the anteroposterior direction was 3.20 ± 0.67 cm for the young, which showed a smaller displacement than the elderly (4.55 ± 0.9 cm, p <0.05). It was found that the elderly had the largest and fastest displacements of center of pressure in the antero-posterior direction than young adults. This increased amplitude of oscillation for the elderly causes a slower response in the recovery of instability, thus increasing the probability of falling in this population.

Comparação da estabilidade postural em idosas residentes em instituição de longa permanência e praticantes de exercício físico / Comparison of stability in postural older residents in establishment of long stay and practicing of exercise

O equilíbrio corporal constitui uma importante capacidade para manutenção das atividades funcionais de idosos. A prática de exercícios físicos constitui um componente fundamental para a prevenção e reabilitação do equilíbrio. O objetivo deste estudo foi avaliar o equilíbrio corporal de idosas praticantes de exercícios físicos e idosas sedentárias asiladas da cidade de Londrina-PR. A amostra foi constituída de 36 idosas, com idades de 60 a 85 anos, divididas em dois grupos: fisicamente ativas (n=18) e asiladas sedentárias (n=18). A avaliação do equilíbrio estático na plataforma de força foi realizada em apoio bipodal durante 30 segundos com olhos abertos e fechados. Foram quantificados os deslocamentos do centro de pressão (CP) nas direções médio lateral (ML) e ântero-posterior (AP). Verificou-se oscilação do CP ML, 1,63±0,48 (ativas) e 2,50±0,59 (asiladas) com informação visual e 2,10±0,59 (ativas) e 2,75±1,16 (asiladas) sem informação visual e no CP AP (1,80±0,80) para as idosas ativas; 2,14±1,07 nas asiladas) com olhos abertos e 2,11±1,06 (ativas) e 2,13±0,94 (asiladas) com olhos fechados. Conclui-se que idosas praticantes de exercício físico possuem maior estabilidade postural quando comparados com as idosas asiladas.

Body balance is an important capability for maintenance of functional activities of older people. The physical exercise is an essential component in the prevention and rehabilitation of balance. The aim of this study was to assess the body balance of elderly practicing of physical and sedentary institutionalized city of Londrina-PR. The sample consisted of 36 elderly, aged 60-85 years, divided into two groups: physically active (n=18) and sedentary institutionalized (n=18). Static balance was assessed in a force platform during 30 seconds in bipedal stance both, with eyes opened and closed. The variables analyzed were the center of pressure (COP) displacement in the medial lateral (ML) and anteroposterior (AP) direction. COP-ML displacement were 1.63 ± 0.48 (active) and 2.50 ± 0.59 (institutionalized) eyes opened and 2.10 ± 0.59 (active) and 2.75 ± 1.16 (institutionalized) eyes closed and the COP-AP displacement were 1.80 ± 0.80 for older active, 2.14 ± 1.07 (institutionalized) eyes opened and 2.11 ± 1.06 (active) and 2.13 ± 0.94 (institutionalized) eyes closed. We conclude that elderly practitioners of exercise have greater postural stability compared to institutionalized elderly sedentary.

Effects of a full season on stabilometric parameters of team handball elite athletes / Efeitos da temporada completa em parâmetros estabilométricos em atletas de handebol de elite / Efectos de la temporada completa en parámetros estabilométricos en atletas de balonmano de élite

It is unclear whether athletes change their postural control over the course of a full sport season, or become more asymmetrical with respect to their neuromuscular performance over the same period. The aim of this study was to investigate the effects of a full sport season on the postural control of team handball elite athletes. Ten healthy, elite male team handball players performed bipodal standing (BP) and right and left unipodal standing (UP) during 30s. We used the RMS and speed of the center of pressure to describe postural sway. For the BP task, the sway was lower at the end of the season (p<0.005). For the UP tasks, the sway was lower at the end of the season only for the non-dominant limb (p<0.001). Differences between limbs were observed only at the end of the season (p<0.03). In conclusion, a full team handball season did not lead to deterioration of the athletes' postural control, but by the end of the season, the athletes were more asymmetrical.

Não é claro na literatura científica se atletas mudam seu controle postural ao longo de uma temporada esportiva, ou mesmo se tornam mais assimétricos em relação ao seu desempenho neuromuscular durante o mesmo período. O objetivo deste estudo foi investigar os efeitos de uma temporada esportiva completa no controle postural de atletas de elite do handebol. Dez jogadores de elite de handebol, saudáveis, realizaram a tarefa de postura ereta quieta bipodal (BP) e unipodal direito e esquerdo durante 30 segundos. Foi utilizada a RMS e a velocidade do centro de pressão para descrever a oscilação postural. Para a tarefa de BP, a oscilação foi menor após a temporada esportiva (p < 0,005). Para as tarefas unipodais, a oscilação foi menor após temporada esportiva apenas para o membro não dominante (p < 0,001). Apenas após a temporada, foram observadas diferenças entre os membros (p < 0,03). Em conclusão, uma temporada esportiva para o handebol não levou à deterioração do controle postural dos atletas, entretanto no final da temporada, os atletas apresentaram-se mais assimétricos.

No está claro en la literatura científica si los atletas cambian su control postural a lo largo de una temporada deportiva o incluso si llegan a ser más asimétricas en relación con su rendimiento neuromuscular durante el mismo período. El objetivo de este estudio fue investigar los efectos de una temporada deportiva completa en control postural de deportistas de elite de balonmano. Diez jugadores de balonmano de élite, sanos, llevaron a cabo la tarea de la tranquilidad de la postura de pie bipodal (BP) y unipodal izquierda y derecha durante 30 segundos. RMS fue utilizado y la velocidad del centro de presión para describir el balanceo postural. Para la tarea de BP, la oscilación fue menor después de la temporada de deportes (p < 0,005). Para unipodais las tareas, la oscilación fue menor después de la temporada deportiva para el miembro no dominante (p < 0,001). Solamente después de la temporada, se observaron diferencias entre los miembros (p < 0,03). En conclusión, una temporada de deportes para el balonmano no conduce al deterioro del control postural de los atletas, sin embargo al final de la temporada, los atletas presentaron más asimétrica.

Síndrome da apneia obstrutiva do sono (Saos) e sonolência diurna excessiva (SDE): influência sobre os riscos e eventos de queda em idosos / Obstructive sleep apnea syndrome (OSA) and excessive daytime sleepiness (EDS): influence about the risks and falling events in elderly people

INTRODUÇÃO: Muitos países vêm experimentando o processo de envelhecimento populacional e a consequente elevação das doenças associadas a ele, como dificuldade de manter o equilíbrio, perdas na qualidade do sono e síndrome da apneia obstrutiva do sono (Saos). OBJETIVOS:Investigar a correlação entre a Saos e sonolência diurna excessiva (SDE) com os riscos e eventos de quedas em indivíduos idosos. MATERIAIS E MÉTODOS:Estudo descritivo, comparativo, de corte transversal com amostra de 75 indivíduos com idade igual ou superior a 60 anos, gêneros masculino e feminino. Foram utilizados o mini-exame do estado mental; escalas de depressão geriátrica simplificada; de sonolência de epworth; de avaliação do equilíbrio de tinneti; índice de massa corporal (IMC); registros estabilométricos das oscilações posturais ântero-posterior (AP) e médio-lateral (ML). RESULTADOS: Maior prevalência de Saos no gênero masculino. Não foi encontrada correlação com significância estatística (Pearson, p ≤ 0,01) entre as variáveis IMC e estabilometria. Não houve correlação estatisticamente significativa (ANOVA, p ≤ 0,05) entre IMC (subgrupos normal, sobrepeso, graus I, II, III, e IV) e estabilometria; entre os graus de severidade de Saos e estabilometria; entre dados estabilométricos de subgrupos de IMC e mesmo grau de severidade de Saos; entre dados estabilométricos de subgrupos de IMC e diferentes graus de Saos; entre os diferentes graus de Saos (GC, G1), (GC e G2), subgrupos de IMC e registros estabilométricos. CONCLUSÃO: Não foram encontrados resultados que corroborassem a hipótese de proporcionalidade entre graus de severidade de Saos, IMC e registro estabilométrico.

INTRODUCTION:Many countries are experiencing population aging process, and the consequent rise of diseases associated with it as difficulty maintaining balance, loss in quality of sleep apnea syndrome and obstructive sleep apnea (OSA). OBJECTIVES: Investigating the correlation between obstructive sleep apnea (OSA) and excessive daytime sleepiness (EDS) associated to the risks and falling events in elderly people. MATERIALS AND METHODS: A descriptive, comparative cross-sectional research was done using a convenience sample of 75 individuals aged over 60 years, men and women. The procedures were performed: application of the mini-mental state examination; simplified geriatric depression scale, Epworth sleepiness scale; Tinneti assessment scale balance; weight and height measuring; calculation of body mass index (BMI), three stabilometric records of the postural oscillation on front-to-back (FB) and side-to-side ways (SS). RESULTS: Higher prevalence of OSA in men. The correlations made between variables BMI and stabilometry found no statistically significant correlation (Pearson’s, p ≤ 0.01). For the other statistical calculations it was used the method one way ANOVA (p ≤ 0.05). It was decided to divide the BMI (normal subgroups, I, the overweight class, II, III and IV) and relate it to stabilometry; was the correlation between the severity of OSA and stabilometry without regard to BMI; was also made to correlate the data stabilometric subgroups of BMI with the same degree of severity of OSA; correlation was performed between the data subsets stabilometric BMI and different degrees of OSA, and all those who showed no statistical significance. When correlated with different degrees of OSA group (G1), (GC and G2) and BMI subgroups with stabilometric records, no statistically significant correlation was established. CONCLUSION: It was not possible to determine quantitative values of the variables that promote the prevention of falling events in elderly people.

Postural balance in patients with social anxiety disorder

Body stability is controlled by the postural system and can be affected by fear and anxiety. Few studies have addressed freezing posture in psychiatric disorders. The purpose of the present study was to assess posturographic behavior in 30 patients with social anxiety disorder (SAD) and 35 without SAD during presentation of blocks of pictures with different valences. Neutral images consisted of objects taken from a catalog of pictures, negative images were mutilation pictures and anxiogenic images were related to situations regarding SAD fears. While participants were standing on a force platform, similar to a balance, displacement of the center of pressure in the mediolateral and anteroposterior directions was measured. We found that the SAD group exhibited a lower sway area and a lower velocity of sway throughout the experiment independent of the visual stimuli, in which the phobic pictures, a stimulus associated with a defense response, were unable to evoke a significantly more rigid posture than the others. We hypothesize that patients with SAD when entering in a situation of exposure, from the moment the pictures are presented, tend to move less than controls, remaining this way until the experiment ends. This discrete body manifestation can provide additional data to the characterization of SAD and its differentiation from other anxiety disorders, especially in situations regarding facing fear.

Avaliação do controle postural em adultos jovens através da posturografia dinâmica Foam-laser e plataforma de força / Evaluation of the postural control in young adults by use of foam-laser dynamic posturography and power plataform

Uma das tarefas mais importantes do sistema do controle postural humano é a manutenção do equilíbrio do corpo sobre a base de apoio fornecida pelos pés. Como um sensor de gravidade, o sistema vestibular é uma das ferramentas mais importantes do sistema nervoso no controle da postura. Quando há um desequilíbrio neste sistema o indivíduo passa a apresentar um conjunto de sintomas no qual a vertigem geralmente é preponderante. Objetivou-se no presente estudo avaliar e correlacionar o controle postural de adultos jovens através da posturografia dinâmica Foam-Laser (FLP) e plataforma de força. Para a realização do estudo participaram 31 voluntários (19 homens e 11 mulheres) sendo submetidos à avaliação do controle postural através da posturografia dinâmica Foam-Laser e plataforma de força simultaneamente. Para análise dos dados registrados na plataforma de força, utilizou-se o programa MATLAB® 7.4. Os resultados da FLP foram obtidos através da fórmula matemática para cálculos de ângulos de oscilações apresentados. Os resultados revelaram que houve forte correlação entre os valores obtidos nos testes de organização sensorial (SOT) e a área de deslocamento do centro de pressão (CP) registrada pela plataforma de força em todos os SOT. Nos SOT III, V e VI, respectivamente, observou-se forte correlação entre os resultados dos exames da FLP e plataforma de força, com r = -0,78, r = -0,70 e r = -0,80. Conclui-se que a FLP é um método eficaz para avaliação do equilíbrio, e seus resultados demonstraram forte correlação com a área de deslocamento do centro de pressão.

One of the most important tasks of the human postural control system is to keep the body balanced on the base of support provided by the feet. As a gravity sensor, the vestibular system is one of the most important tools of the nervous system in the control of the posture. When there is a malfunction in this system the individual starts to present a group of symptoms in which the vertigo generally is preponderant. The present study had as objective to correlate the results of the postural control evaluation in young peolple obtained through the Dynamic Posturography Foam-laser (FLP) and platform force. For the accomplishment of the study were invited 31 volunteers (19 men and 11 women) that were submitted to the evaluation of the postural control through the Dynamic Posturography Foam-laser and power platform simultaneously. The results reveled that there was strong correlation among the values obteined in the tests of sensorial organization (TOS) and area displacement pressure center (PC) at power platform in all TOS. In TOS III, V e VI respectively, correlation was observed strong enters the results of the examinations in FPL and power platform, with r = - 0,79, r = 0,70 and r = - 0,80. This study concludes that the FLP is a very useful method for evaluation of the balance, and this results show strong correlation with pressure center displacement area.

La medición del control postural con estabilometría- una revisión documental / Measurment of Postural Control Through Stabilometry- a Literature Review

La estabilometría es el estudio del equilibrio que permite analizar el control postural y su relacion con la estabilidad en bípedo. Herramientas de alta tecnología se utilizan para medir la estabilidad en bípedo de forma cuantitativa con base en la posición del centro de gravedad de la persona determinado por la distribución de presiones plantares. Este artículo revisa el conocimiento científico sobre los conceptos en el trastorno de la estabilometría y la variedad de uso de estas herramientas en diferentes poblaciones y diagnósticos con base en artículos científicos encontrados en los últimos diez años en revistas indexadas. Se recomienda expandir el uso de las plataformas de fuerza que existen en Colombia a la estabilometría.

Stabilometry is the study of balance which permits the analysis of postural control as it relates to stability in standing. High tech tools are used to measure standing stability cuantitatively based on the position of the center of gravity of the person determined by his/ her distrubution of plantar pressures. This article reviews scientific knowlege regarding the concepts surrounding stabilomitry and the wide variety of uses of these tools in different populations and diagnoses based on scientific articles found in the last ten years in indexed journals. Expanding the use of the force plates that exist in Colombia to include stabilometry is recommended.

Modelo matemático para calcular el centro de presión plantar sobre una superficie dinámica / Mathematical Model To Calculate The Plantar Centre Pressure Over An Unstable Surface

El balance postural es la capacidad para mantener los segmentos corporales ante la acción de la fuerza de gravedad. Es una cualidad compleja del movimiento corporal, la cual depende de la interacción de los sistemas visual, vestibular y propioceptivo. Una descripción cuantitativa del balance postural se realiza mediante el cálculo del centro de presión plantar,considerado como el punto en el cual se concentra el promedio de todas las presiones ejercidas por el cuerpo sobre una superficie. Los estudios se han centrado en el análisis del balance postural bajo una superficie estática, sin embargo, las diversas praxias motoras del ser humano, como la marcha, la práctica lúdica y deportiva, la carrera y el mantenimiento de la postura exigen conservar el equilibrio ante terrenos inestables. Por ello, el objetivo del siguiente trabajo de investigación con-sistió en proponer un modelo matemático para calcular el centro de presión plantar, las fuerzas de reacción y los momentos articulares en dos dimensiones bajo una superficie inestable como indicadores de la estabilidad postural. Se fundamentó en elementos de la mecánica clásica como la condición de equilibrio estático y la condición de momento inicial para el cálculo del centro de presión plantar, las fuerzas de reacción y los momentos articulares. Los resultados mostraron las ecuaciones para el cálculo el centro de presión plantar, las fuerzas de reacción y los momentos en dos dimensiones. En conclusión, este trabajo es la base para el desarrollo de trabajos futuros como la construcción de un estabilómetro y la evaluación de tratamientos relacionados con la optimización del balance.

The postural balance is the capacity of maintain the corporal segments to the gravity force. It's a complex quality of corporal movement and it has dependence to the visual, vestibular and propioceptive system. A quantitative description of the corporal balance could be made through calculating the plantar pressure centre. It's a concentrated point of average pressures exerted over a surface. The research had studied the postural balance in a static surface; however, the va-rious motor activities of humans as gait, run and maintain the posture are developed in unstable surfaces. For this reason, the aim of this work was to propose a mathematical model to calculate the plantar pressure centre, the reaction forces and the joint moments in two dimensions into an unstable surface like indicators about postural stability. It based in the static equilibrium and the initial moment condition. The results showed equations to calculate the plantar pressure centre, the reaction forces and the joint moments. In conclusion, this work allows the development of next works to make a stabilometer to measure quantitatively the postural balance and to make comparative studies about many topics of treatment in the balance optimization.

Equilíbrio estático da criança com baixa visão por meio de parâmetros estabilométricos / Static balance of low vision children using stabilometric parameters

Introdução: A visão é considerada um dos mais importantes meios de captação das informações do ambiente, sendo fundamental para o processo de desenvolvimento da criança. Objetivos: Cientes da participação da visão na manutenção do equilíbrio e no desenvolvimento biopsicossocial do ser humano e considerando os fatores decorrentes da perda ou limitação visual, esta pesquisa objetivou analisar o equilíbrio em postura ortostática de crianças com baixa visão, de faixa etária de 8 a 11 anos, de ambos os sexos(grupo experimental), comparando com o equilíbrio de crianças normais de ambos os sexos e mesma faixa etária (grupo controle), por meio de parâmetros estabilométricos. Materiais e métodos: Para a obtençãodas oscilações posturais (deslocamento radial e velocidade de deslocamento) foi utilizada uma plataforma estabilométrica. Resultados: Considerando-se os índices (média e desvio padrão) de deslocamento radial apresentados pelos grupos experimental e controle, observou-se que não houve diferença significante na condição olhos fechados (p > 0,05). Já na condição olhos abertos, houve maior deslocamento radial do grupo experimental em relação ao grupo controle (p < 0,05). Analisando-se os índices (média e desvio padrão) de velocidade de deslocamento entre os grupos controle e experimental, observou-se que em ambas as condições (olhos abertos e olhos fechados) o grupo controle apresentou maior velocidade de deslocamento quando comparado ao grupo experimental (p < 0,01). Conclusão: A partir dos resultados apresentados, concluímos que a baixa visão parece influenciar negativamente a estabilidade em postura ortostática, bem como a velocidade de ajuste postural, prejudicando o equilíbrio corporal.

Introduction: Vision is considered one of the most important means of capturing the information from the environment. It is central to the process of child development. Objectives: Aware of the contribution of vision on balance maintenance and on human biopsychosocial development, and considering the factors resulting from loss or impairment of vision, this research objected to analyze the balance on orthostatic posture of low vision children, from 8 to 11 years old, of both genders (experimental group) comparing with normal children balance of both genders and same age (control group) using stabilometric parameters. Materials and methods: A stabilometric plataform was used to measure the postural oscillations (radial displacement and displacement speed). Results: Considering the experimental and control groups radial displacement rates (media and standard diversion), it could be observed that there was no significant difference on the closed eyes condition (p > 0,05). On the opened eyes condition, there was a bigger radial displacement of the experimental group comparing to the control group (p < 0,05). Analysing the displacement speed rates of the control and experimental groups, it could be observed that in both conditions (closed and opened eyes) the control group presented the higher displacement speed when compared to the experimental one (p < 0,01). Conclusion: After the presented results, we concluded that low vision might have a negative influence on the orthostatic posture stability as well as on the postural adjustment speed, damaging the body balance.

Normal Ranges of the Stabilometry by Age Groups / 대한이비인후과학회지

Stabilometry is a basic vestibular function test to detect abnormal body sway in upright standing posture. Subject were instructed to stand on the platform of stabilometer for 60 seconds when eyes open and eyes closed. And the recordings were analyzed with the pattern, A-P diameter, lateral diameter, distance and movement area. 178 normal Koreans(86 male, 92 female) were divided into 8 groups aged of 5-9, 10-14, 15-19, 20-29, 30-39, 40-49, 50-59 and 60-69. And the results were as follow 1) Centripetal type was the most frequent body sway pattern when eyes open and eyes closed(93% when eyes open, 94% when eyes closed). There were no significant differences between each age groups, sexes, and eyes open and eyes closed, respectively. 2) The mean of A-P diameter in all age groups was 1.13+/-0.33cm when eyes open and 1.50+/-0.48cm when eyes closed, lateral diameter was 1.09+/-0.33cm when eyes open and 1.47+/-0.50cm when eyes closed, distance of movement was 92.85+/-25.21cm when eyes open and 142.34+/-49.34cm when eyes closed, and area of movement was 0.33+/-1.49cm2 when eyes open and 6.02+/-4.53cm2 when eyes closed. 3) A-P diameter, lateral diameter, distance and area of movement were increased in age groups below 14 years and over 60 years, but there were no significant differences in groups ranged in age from 15 to 59 years. There was no significant difference between both sexes.