Movement technique analysis and sports injuries prevention in the elderly physical training / Análise técnica de movimento e prevenção de lesões esportivas no treinamento físico de idosos / Análisis técnico del movimiento y prevención de lesiones deportivas en el entrenamiento físico de personas mayores

ABSTRACT Introduction: Physical training for the elderly is extremely popular. However, there is a lack of analysis on sports injuries in the elderly. Objective: Study the analysis of movement in sports training techniques and preventing sports injuries in the elderly. Methods: Participating in a 15-minute running and warm-up activity before using the standard FMS test kit, they followed seven test movements, each repeated three times; they did so during six weeks of training based on the recommendations for the prevention of sports injuries presented in this paper. Results: Among the 14 elderly subjects with a total FMS score <14 points, most functional motor scores were 15-16 points, of which 19 points were high, and 9 points were low. In the intervention based on the perspective of sports injuries, the FMS measurement value of the elderly was much better than before, and the evaluation of the technical analysis of movement after the correction was significantly higher than before. Conclusion: The prevention of sports injuries proposed in this paper can effectively help the elderly to prevent sports injuries. This paper considers the FMS trial design as an example for analyzing movements in sports training of the elderly and formulating standards. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

RESUMO Introdução: O treinamento físico em idosos é extremamente popular, entretanto, carece de análise sobre as lesões esportivas em idosos. Objetivo: Estudar a análise do movimento nas técnicas de treinamento esportivo e a prevenção de lesões esportivas em idosos. Métodos: Participando de uma atividade de 15 minutos de corrida e aquecimento antes de utilizar o kit de teste padrão FMS, seguiram-se sete movimentos de teste, cada um deles repetidos 3 vezes; fizeram-no durante seis semanas de treinamento com base nas recomendações de prevenção de lesões esportivas apresentadas neste trabalho. Resultados: Entre os 14 sujeitos idosos com pontuação total de FMS <14 pontos, a maioria das pontuações motoras funcionais foram de 15-16 pontos, dos quais 19 pontos foram altos e 9 pontos foram baixos. Na intervenção baseada sob a ótica das lesões esportivas, o valor de medição FMS dos idosos foi muito melhor do que anteriormente, e a avaliação da análise técnica do movimento após a correção foi significativamente maior do que aquela antes da correção. Conclusão: A prevenção de lesões esportivas proposta neste trabalho pode efetivamente ajudar os idosos a prevenir as lesões esportivas. Este documento considera o projeto de ensaio do FMS como um exemplo para analisar os movimentos no treinamento esportivo das pessoas idosas e para formular padrões. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.

RESUMEN Introducción: El entrenamiento físico en las personas mayores es muy popular, sin embargo, hay una falta de análisis sobre las lesiones deportivas en las personas mayores. Objetivo: Estudiar el análisis del movimiento en las técnicas de entrenamiento deportivo y la prevención de lesiones deportivas en las personas mayores. Métodos: Participando en una actividad de carrera y calentamiento de 15 minutos antes de utilizar el kit de prueba estándar de FMS, se siguieron siete movimientos de prueba, cada uno repetido 3 veces; lo hicieron durante seis semanas de entrenamiento basado en las recomendaciones para la prevención de lesiones deportivas presentadas en este trabajo. Resultados: Entre los 14 sujetos de edad avanzada con una puntuación total de FMS <14 puntos, la mayoría de las puntuaciones motoras funcionales eran de 15-16 puntos, de los cuales 19 puntos eran altos y 9 puntos eran bajos. En la intervención basada en la perspectiva de las lesiones deportivas, el valor de medición de la FMS de los ancianos fue mucho mejor que antes, y la evaluación del análisis técnico del movimiento después de la corrección fue significativamente mayor que antes de la corrección. Conclusión: La prevención de las lesiones deportivas propuesta en este artículo puede ayudar eficazmente a las personas mayores a prevenir las lesiones deportivas. Este documento considera el diseño de la prueba FMS como un ejemplo para analizar los movimientos en el entrenamiento deportivo de las personas mayores y para formular normas. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.

Educação física escolar em unidades prisionais: elementos para se pensar sobre a educação "por entre as grades" / School physical education in prison units: elements to think about education "through the grates" / Educación física escolar en unidades prisioneras: elementos para pensar sobre la educación "a través de las rejillas"

O objetivo do estudo foi identificar e analisar aspectos que caracterizam as aulas de Educação Física em unidades prisionais da Região dos Inconfidentes, MG. Para tal, foi realizada uma pesquisa qualitativa, a partir da entrevista semiestruturada com professores licenciados em Educação Física atuantes em escolas prisionais. Foi identificado que, devido às regras impostas pelas unidades prisionais, as aulas passam por adaptações e acontecem em salas de aula, com a proibição e/ou restrição do uso de materiais pedagógicos e de determinadas metodologias de ensino. Segundo os participantes, acresce a quase ausência dos movimentos corporais, o que acaba por subverter a lógica e os preceitos da Educação Física escolar, alicerçadas no conceito de Cultura Corporal de Movimento e nos objetivos definidos pelos documentos legais (AU).

The aim of the study was to identify and analyze aspects that characterize Physical Education classes in prison units in the Inconfidentes Region, MG. To this end, a qualitative research was carried out, based on a semi-structured interview with teachers licensed in Physical Education working in prison schools. It was identified that, due to the rules imposed by the prison units, classes undergo adaptations and take place in clas-srooms, with the prohibition and / or restriction of the use of teaching materials and certain teaching methodologies. According to the partici-pants, there is an almost absence of body movements, which ends up subverting the logic and precepts of school Physical Education, based on the concept of Body Culture of Movement and objectives defined by legal documents (AU).

El objetivo del estudio fue identificar y analizar aspectos que caracterizan las clases de Educación Física en unidades penitenciarias de la Región de los Inconfidentes, MG. Para ello, se llevó a cabo una investi-gación cualitativa, basada en una entrevista semiestructurada a profeso-res titulados en Educación Física que laboran en escuelas penitenciarias. Se identificó que, debido a las normas impuestas por las unidades peni-tenciarias, las clases sufren adaptaciones y se desarrollan en las aulas, con la prohibición y / o restricción del uso de materiales didácticos y determinadas metodologías de enseñanza. Según los participantes, hay una casi ausencia de movimientos corporales, lo que acaba subvirtiendo la lógica y los preceptos de la Educación Física escolar, basada en el con-cepto de Cultura Corporal del Movimiento y objetivos definidos por los documentos legales (AU).

Análisis tridimensional de movimientos mandibulares bordeantes en participantes dentados totales / Three-dimensional analysis of mandibular border movements in fully dentate participants

Las articulaciones temporomandibulares y la musculatura asociada, permiten que la mandíbula se desplace en los tres planos del espacio (sagital, frontal y horizontal), de esta forma la mandíbula puede realizar movimientos mandibulares complejos. Hace varias décadas que los movimientos bordeantes mandibulares son estudiados, sin embargo, en un principio los estudios se realizaban en dos dimensiones (2D). En la actualidad, gracias al articulógrafo electromagnético (EMA) 3D es posible realizar el estudio de la cinemática mandibular en tres dimensiones (3D). El objetivo del siguiente estudio es analizar los movimientos mandibulares bordeantes (sagital, frontal y horizontal), por medio de la articulografía electromagnética 3D. En el estudio, participaron 11 personas de 31,9 ± 5,7 años en promedio (mujeres 30,2 ± 2,9 y hombres 34,0 ± 7,8) completamente dentados de primer molar a primer molar, sin trastornos temporomandibulares ni tratamiento previo de ortodoncia. Los archivos fueron procesados mediante scripts, desarrolladas en MATLAB®. Entre los resultados más relevantes, se encontró diferencia estadística entre hombres y mujeres en relación al área Frontal del polígono de Posselt, y los resultados del área del polígono sagital de todos los participantes, fue mayor que en estudios previos.

The temporomandibular joints and associated muscles allow the mandible to move in the three planes (sagittal, frontal and horizontal), in this way the jaw can perform complex mandibular movements. For several decades, mandibular border movements have been studied. However, studies were initially carried out in two dimensions (2D). At the present time, it is possible to analyze mandibular kinematics in three dimensions (3D), with the 3D electromagnetic articulograph (EMA). The objective of the study is to evaluate the mandibular border movements (sagittal, frontal and horizontal), using 3D electromagnetic articulation. In this analysis, 11 subjects 31.9 ± 5.7 years of age on average, participated (women 30.2 ± 2.9 and men 34.0 ± 7.8) completely dentate patients, from first to first molar, with no temporomandibular disorders or orthodontic pretreatment. Files were processed using scripts, developed in MATLAB®. Among the most relevant results, a statistical difference was found between men and women in relation to the Frontal area of Posselt polygon, and results of the sagittal polygon area of all the participants were greater than those reported in previous studies.

Association of sex-related differences in body composition to change of direction speed in police officers while carrying load / Asociación de diferencias relacionadas con el sexo en la composición corporal para cambiar la velocidad de dirección de oficiales de policía durante el transporte de carga

Regardless of sex or body size, police tasks may require officers to change direction speed (CODS) under occupational loads. The purpose of this study was to investigate body composition and CODS in female and male police cadets in both unloaded and occupationally loaded conditions. Body composition and CODS of 51 female (FPC) and 70 male police cadets (MPC) were assessed. Six body composition indices were used: Body mass index (BMI), percent body fat (PBF), percent of skeletal muscle mass (PSMM), protein fat index (PFI), index of hypokinesia (IH), and skeletal muscle mass index (SMMI). The CODS was assessed by Illinois Agility Test (IAT) and IAT while carrying a 10-kg load (LIAT). An independent sample t-test was used to identify the differences between the sexes. The regression determined associations between body composition and LIAT. The alpha level was set at p < 0.05 a priori. MPC had significantly higher (p < 0.001) BMI, PSMM, PFI and SMMI and lower PBF and IH than FPC. MPC were also faster in IAT and LIAT, carrying lower relative loads that imparted less of an impact on CODS performance. Body composition was strongly associated with the time to complete LIAT (R2 = 0.671, p < 0.001). Difference in relative load and body composition influenced CODS performance in both unloaded and loaded conditions. Thus, optimizing body composition through increasing skeletal muscle mass and reducing fat mass could positively influence unloaded and loaded CODS performance and improve elements of police task performance.

El trabajo policial puede requerir que los oficiales cambien la velocidad de dirección (CVD) bajo cargas ocupacionales, indistintamente del sexo o tamaño corporal. El propósito de este estudio fue investigar la composición corporal y los CVD en cadetes de policía de ambos sexos, tanto en condiciones de descarga como de trabajo. Se evaluaron la composición corporal y los CVD de 51 mujeres (CPF) y 70 cadetes de policía masculinos (CPM). Se utilizaron seis índices de composición corporal: índice de masa corporal (IMC), porcentaje de grasa corporal (PGC), porcentaje de masa muscular esquelética (PMME), índice de grasa proteica (IGP), índice de hipocinesia (IH) e índice de masa muscular esquelética (IMME). El CVD fue evaluado por Illinois Agility Test (IAT) y IAT mientras transportaba una carga de 10 kg (LIAT). Se usó una prueba t de muestra independiente para identificar las diferencias entre los sexos. La regresión determinó asociaciones entre la composición corporal y LIAT. El nivel alfa se estableció en p <0,05 a priori. CPM registraron un IMC, PMME, PGC y IMME significativamente más altos (p <0,001) y PGC e IH más bajos que las mujeres (CPF). Los CPM también fueron más rápidos en IAT y LIAT, llevando cargas más bajas, las que tuvieron un impacto menor en el rendimiento de CVD. La composición corporal estaba asociada con el tiempo para completar LIAT (R2 = 0,671, p <0,001). La diferencia en la carga relativa y la composición corporal influyeron en el rendimiento de CVD tanto en condiciones descargadas como cargadas. Por lo tanto, la optimización de la composición corporal a través del aumento de la masa del músculo esquelético, y la reducción de la masa grasa podrían influir de manera positiva en el rendimiento de CVD descargados y cargados, mejorando el rendimiento del trabajo policial.

In vivo exposure for fear of pain and avoidance of movement in low back pain / Exposición en vivo al miedo al dolor y evitación del movimiento en dolor lumbar / Exposição ao vivo para o medo da dor e evitação do movimento em dor lombar

ABSTRACT Objectives: to verify the effects of hierarchization and in vivo exposure for fear of pain, avoidance of movement, and anxiety in chronic low back pain. Methods: quasi-experimental study. The 27 patients who participated graded the damage associated with the movements in each of the 40 activities of daily living depicted in pictures using a scale from 0 to 100. The patients chose five out of all the activities that received a score higher than 50 to carry out the exposure. The intensities of fear and anxiety were measured before and after each exposure session. Results: the frequencies of the gender were equal, and the mean age was 44.9 years. The activities chosen more frequently for the exposure were shoveling (33.3%) and running (33.3%). There was reduction of fear and anxiety before and after exposure (p<0.001). Conclusions: hierarchization and in vivo exposure were effective in reducing fear and anxiety.

RESUMEN Objetivos: verificar los efectos de la jerarquización y exposición viva al supuesto miedo al dolor y evitar el movimiento y la ansiedad en pacientes con dolor lumbar crónico. Métodos: estudio cuasiexperimental. Los 27 pacientes que participaron clasificaron el dolor de cada uno de los 40 movimientos de la actividad cotidiana representados en fotos, utilizando una escala de 0-100. Entre las actividades clasificadas con más de 50, eligieron 5 para realizar la exposición. La intensidad del miedo y la ansiedad fueron medidas antes y después de cada sesión de exposición. Resultados: la muestra expresó equivalencia entre sexos, media etaria de 44,9 años. Las actividades más elegidas para la exposición fueron: trabajar con la pala (33,3%) y correr (33,3%). Hubo reducción del miedo y de la ansiedad antes y después de las exposiciones (p<0,001). Conclusiones: la jerarquización y exposición vivas fueron efectivas para reducir el miedo y la ansiedad.

RESUMO Objetivos: verificar os efeitos do uso da hierarquização e exposição ao vivo para a crença de medo da dor e evitação do movimento e ansiedade em pacientes com dor lombar crônica. Métodos: estudo quase-experimental. Os 27 pacientes que participaram graduaram o dano de cada um dos 40 movimentos de atividades da vida diária representados em fotos, utilizando uma escala de 0 a 100. Dentre as atividades graduadas acima de 50, escolheram 5 para realizar a exposição. As intensidades do medo e da ansiedade foram mensuradas antes e depois de cada sessão de exposição. Resultados: a frequência entre os sexos foi equitativa, a média da idade foi de 44,9 anos. As atividades mais escolhidas para a exposição foram trabalhar com a pá (33,3%) e correr (33,3%). Houve redução do medo e ansiedade antes e após as exposições (p<0,001). Conclusões: a hierarquização e exposição ao vivo foram efetivas na redução do medo e da ansiedade.

Effect of Leap Motion-based 3D Immersive Virtual Reality Usage on Upper Extremity Function in Ischemic Stroke Patients / Efeito do uso imersivo da realidade virtual 3D baseada em movimento de salto na função de extremidade superior em pacientes com AVC isquêmico

ABSTRACT Immersive virtual reality (VR) is a technology that provides a more realistic environmental design and object tracking than ordinary VR. The aim of this study was to investigate the effectiveness of immersive VR on upper extremity function in patients with ischemic stroke. Sixty-five patients with ischemic stroke were included in this randomized, controlled, double-blind study. Patients were randomly divided into VR (n = 33) and control (n = 32) groups. The VR group received 60 minutes of the upper extremity immersive VR rehabilitation program and the control group received 45 minutes of conventional therapy and 15 minutes of a sham VR program. Rehabilitation consisted of 18 sessions of therapy, three days per week, for six weeks. The outcome measures were the Action Research Arm Test (ARAT), Functional Independence Measure (FIM), Fugl-Meyer Upper Extremity Scale (FMUE) and Performance Assessment of Self-Care Skills (PASS). In both the VR and control groups all parameters except the PASS improved over time. However independent t-test results showed that all of the FMUE, ARAT, FIM and PASS scores were significantly higher in the VR group compared with the control (p < 0.05). The minimal clinically important difference (MCID) scores of the FMUE and ARAT were higher than the cut-off MCID scores described in the literature in the VR group, whereas the FIM scores were below the cut-off MCID scores. All scores in the control group were below the cut-off scores. Immersive VR rehabilitation appeared to be effective in improving upper extremity function and self-care skills, but it did not improve functional independence.

RESUMO A VR imersiva é uma tecnologia que fornece design ambiental e rastreamento de objetos mais realistas do que a VR comum. O objetivo deste estudo foi investigar a eficácia da VR imersiva na função da extremidade superior em pacientes com AVC isquêmico. Sessenta e cinco pacientes com AVC isquêmico foram incluídos neste estudo randomizado, controlado e duplo-cego (clinictrials.gov. ID: NCT03135418). Os pacientes foram divididos aleatoriamente em VR (n = 33) e controle (n = 32). O grupo VR recebeu 60 minutos do programa de reabilitação imersiva da extremidade superior e o grupo controle recebeu 45 minutos de terapia convencional e 15 minutos de um programa falso de VR. A reabilitação consistiu em 18 sessões de terapia, 3 dias por semana, durante 6 semanas. As medidas de resultado foram Teste de braço de pesquisa-ação (ARAT), Medida de independência funcional (FIM), Escala de extremidades superiores de Fugl-Meyer (FMUE) e Avaliação de desempenho de habilidades de autocuidado (PASS). Nos grupos VR e controle, todos os parâmetros, exceto o PASS, melhoraram com o tempo. No entanto, os resultados dos testes t independentes mostraram que todos os escores FMUE, ARAT, FIM e PASS foram significativamente maiores no grupo VR em comparação ao controle (p <0,05). Os escores de FMUE e ARAT de diferença minimamente clinicamente importante (MCID) foram maiores que os pontos de corte de MCID descritos na literatura no grupo VR, enquanto os escores de FIM estiveram abaixo dos pontos de corte de MCID. Todas as pontuações no grupo controle estiveram abaixo das pontuações de corte. A reabilitação imersiva da VR parece ser eficaz para melhorar a função da extremidade superior e as habilidades de autocuidado, mas não melhora a independência funcional.

Time-motion analysis of competitive surfers: Portuguese championship

SUMMARY BACKGROUND: Time-motion analysis has been used to provide detailed insight into surfers' performance. This study evaluated surfers' activity times at the Portuguese surfing championship in order to account for the time spent in each surfing activity. METHODS: Eighty-seven individually recorded videos of surfers were analyzed, showing their activity over the entire heat, and video analysis software was used to obtain each surfer's activity profile in the competition. RESULTS: The results breakdown by time percentage show that the surfers were paddling 50.9% of the time, sprint paddling for wave 1.9%, were stationary 34.1% of the time, wave riding 3.7%, and involved in miscellaneous activities (e.g., duck diving, board recovery, etc.) 9.4% of the total time. Average times spent in each surfing activity were 18.6 seconds for paddling, 2.9 seconds for sprint paddling for a wave, 21.7 seconds for the stationary period, 11.5 seconds for wave riding, and 6.9 seconds for miscellaneous activities. CONCLUSIONS: The data revealed that the most performed heat activity was paddling, allowing us to conclude that surfing is basically a long-arm paddling activity and that this activity constitutes a specific surfing competition demand, which in turn means that individual surfer's data can be used as a starting point for the development of tailored conditioning training programs.

RESUMO INTRODUÇÃO: A análise temporal dos movimentos tem sido usada para fornecer informações detalhadas sobre o desempenho dos surfistas. O objetivo deste estudo foi avaliar os tempos das atividades dos surfistas em um campeonato português de surfe, em nível nacional, a fim de contabilizar o tempo gasto em cada movimento do surfe. MÉTODOS: Foram realizadas 87 filmagens individuais dos surfistas, durante os diversos heats que decorreram ao longo da competição, sendo estas analisadas com um software para obtenção do perfil das atividades dos surfistas na competição. RESULTADOS: Os dados obtidos revelaram que o movimento de remada correspondeu a 50,9% do tempo total despendido na competição, a remada para apanhar a onda consistiu em 1,9%, o período estacionário compreendeu 34,1%, o ato de apanhar a onda de apenas 3,7% e outras atividades (bico de pato, recuperação da prancha etc.) envolveram 9,4% do tempo total da competição. Os tempos médios gastos em cada atividade de surfe foram de 18,6 segundos para remada, 2,9 segundos para remada para apanhar a onda, 21,7 segundos para o período estacionário, 11,5 segundos para andar de onda e 6,9 segundos para outras atividades. CONCLUSÕES: Os resultados revelaram que o surfe consiste em uma atividade que abrange longos períodos de remada, envolvendo uma demanda energética específica para a prática desse esporte. Os dados obtidos são necessários para o desenvolvimento de estratégias de treinamento que levem em consideração o tempo gasto em cada atividade do surfe e o consequente metabolismo energético envolvido, a fim de que se efetive uma prescrição adequada de um programa de treinamento.

Benign ovarian lesions with restricted diffusion / Lesões ovarianas benignas com restrição na difusão

Abstract Developments in magnetic resonance imaging have expanded its role in the assessment of the female pelvis, including the diagnosis of ovarian lesions. In this setting, diffusion-weighted imaging has proven its diagnostic value, which is particularly important in differentiating between benign and malignant ovarian tumors. In general, the latter show restricted diffusion, whereas the former do not. Exceptions include teratomas, endometriomas, hemorrhagic cysts, ovarian abscesses, ovarian infarction, and some benign stromal tumors. The aim of this review is to draw attention to benign ovarian lesions with restricted diffusion, with a special focus on diffusion-weighted imaging pearls and pitfalls.

Resumo Os recentes desenvolvimentos nas técnicas de ressonância magnética aumentaram o seu papel na avaliação da pelve em mulheres, incluindo o diagnóstico de lesões ovarianas. A imagem ponderada em difusão comprovou ter um valor diagnóstico indiscutível, fato particularmente importante na diferenciação entre tumores ovarianos benignos e malignos. Em geral, os últimos têm restrição na difusão, enquanto os primeiros não. As exceções incluem teratomas, endometriomas, cistos hemorrágicos, abcessos ovarianos, enfarte ovariano e alguns tumores benignos do estroma ovariano. Esta revisão tem como objetivo expor lesões ovarianas benignas com restrição na difusão, com especial enfoque nas pérolas e armadilhas da imagem ponderada em difusão.

Teste de Sentar-Levantar Cinco Vezes: segurança e confiabilidade em pacientes idosos na alta da unidade de terapia intensiva / The Five Times Sit-to-Stand Test: safety and reliability with older intensive care unit patients at discharge

RESUMO Objetivo: Avaliar a segurança e as propriedades clinimétricas do Teste de Sentar-Levantar Cinco Vezes em pacientes mais velhos internados em unidade de terapia intensiva. Métodos: A segurança do teste foi avaliada segundo a incidência de eventos adversos e pela análise dos dados hemodinâmicos e respiratórios. Além disto, a confiabilidade de suas propriedades foi investigada por meio de avaliação de coeficientes de correlação intraclasses, mensuração do erro padrão da média, porcentagem de alteração do erro padrão da média, gráficos de Altman-Bland e de concordância-sobrevivência. Resultados: A adequabilidade do Teste de Sentar-Levantar Cinco Vezes foi identificada como baixa, já que apenas 29,8% dos potenciais participantes cumpriam os critérios de inclusão. Apenas 44% dos pacientes hospitalizados que cumpriam os critérios de inclusão realizaram o teste, sem necessidade de cessação para qualquer dos pacientes. A frequência cardíaca (79,7 ± 10,2bpm/86,6 ± 9,7bpm; p = 0,001) e a pressão arterial sistólica (118 ± 21,4mmHg/129 ± 21,5mmHg; p = 0,031) foram as únicas variáveis com aumento estatisticamente significante, sem evidência de resposta exacerbada ao teste. Além disto, não se relataram eventos adversos, e a confiabilidade tanto entre teste e reteste quanto entre avaliadores foi elevada (coeficiente de correlação entre classes ≥ 0,99). Conclusão: O Teste de Sentar-Levantar Cinco Vezes se comprovou seguro e com excelente confiabilidade. Seu uso clínico no ambiente hospitalar, contudo, pode ser restrito a pacientes adultos mais velhos com elevada funcionalidade.

ABSTRACT Objective: Assess the Five Times Sit-to-Stand Test safety and clinimetric properties in older patients hospitalized in an intensive care unit. Methods: Test safety was assessed according to the incidence of adverse events and through hemodynamic and respiratory data. Additionally, reliability properties were investigated using the intraclass correlation coefficients, standard error of measurement, standard error percentage change, Altman-Bland plot and a survival agreement plot. Results: The overall suitability of the Five Times Sit-to-Stand Test was found to be low, with 29.8% meeting the inclusion criteria. Only 44% of the hospitalized patients who met the inclusion criteria performed the test, with no need for discontinuation in any patient. Heart rate (79.7 ± 10.2bpm/86.6 ± 9.7bpm; p = 0.001) and systolic blood pressure (118 ± 21.4mmHg/129 ± 21.5mmHg; p = 0.031) were the only variables that presented a significant statistical increase, with no evidence of exacerbated response to the test. Additionally, no adverse events were reported from participating and both test-retest and interrater reliability were high (intraclass correlation coefficient ≥ 0.99). Conclusion: The Five Times Sit-to-Stand Test was proven to be safe and to have excellent reliability. Its clinical use, however, may be restricted to high-functioning older adults in hospital settings.

Effects of linear and undulating periodization of strength training in the acceleration of skater children

Aim: This study aimed to compare the effects of linear periodization (LP) and undulating periodization (UP) of strength training on acceleration in skater children. Methods: Twenty-nine girls (9.67±1.29 years-old, 34.47±8.06kg, 1.39±0.13m) were distributed into two groups: linear periodization group (LPG, n=14) and undulating periodization group (UPG, n=15). Six levels of progressive training were designed based on activities such as multi-jumps, plyometrics, sled towing, and facilitated exercises. The training lasted 16 weeks, with a 1-h session on three non-consecutive days per week. The acceleration was recorded by digital videography following the major trochanter of the femur, at four moments and under two conditions: static (SS) and dynamic start (DS) in a rectilinear path. Statistical significance was set at 5%. Results: ANOVA indicated group*moment interaction in SS and DS for velocity (F3,81=7.883; p<0.001; pη2=0.226; F3,81=2.36; p=0.078; pη2=0.08-trend, respectively) and acceleration (F3,81=3.96; p=0.011; pη2=0.128; F3,81=2.92; p=0.039; pη2=0.098, respectively). Both groups increased velocity in SS and DS (UPG/SS: 1st=4.07, 2nd=9.75, 3rd=8.91, 4th=9.25m/s; LPG/SS: 1st=4.27, 2nd=7.13, 3rd=7.61, 4th=7.99m/s; UPG/DS: 1st=8.30, 2nd=8.73, 3rd=8.12, 4th=9.27m/s; LPG/DS: 1st=8.20, 2nd=8.31, 3rd=7.90, 4th=8.96m/s) and acceleration (UPG/SS: 1st=2.00, 2nd=8.69, 3rd=4.71, 4th=5.02m/s2; LPG/SS: 1st=2.37, 2nd=3.39, 3rd=3.68, 4th=4.12m/s2; UPG/DS: 1st=1.78, 2nd=1.97, 3rd=1.65, 4th=2.46m/s2; LPG/DS: 1st=1.67, 2nd=1.70, 3rd=1.48, 4th=1.93m/s2). Conclusion: Both strength training periodization protocols were effective in developing acceleration and velocity in girl skaters over 16 weeks; however, UP was more efficient than LP for improving acceleration.(AU)

Burden, access, and disparities in kidney disease

This article was published in Kidney International volume 95, pages 242-248, https://doi.org/10.1016/j.kint.2018.11.007, Copyright World Kidney Day 2019 Steering Committee (2019) and is reprinted concurrently in several journals. The articles cover identical concepts and wording, but vary in minor stylistic and spelling changes, detail, and length of manuscript in keeping with each journal's style. Any of these versions may be used in citing this article. Note that all authors contributed equally to the conception, preparation, and editing of the manuscript. Kidney disease is a global public health problem, affecting over 750 million persons worldwide. The burden of kidney disease varies substantially across the world, as does its detection and treatment. In many settings, rates of kidney disease and the provision of its care are defined by socio-economic, cultural, and political factors leading to significant disparities. World Kidney Day 2019 offers an opportunity to raise awareness of kidney disease and highlight disparities in its burden and current state of global capacity for prevention and management. Here, we highlight that many countries still lack access to basic diagnostics, a trained nephrology workforce, universal access to primary health care, and renal replacement therapies. We point to the need for strengthening basic infrastructure for kidney care services for early detection and management of acute kidney injury and chronic kidney disease across all countries and advocate for more pragmatic approaches to providing renal replacement therapies. Achieving universal health coverage worldwide by 2030 is one of the World Health Organization's Sustainable Development Goals. While universal health coverage may not include all elements of kidney care in all countries, understanding what is feasible and important for a country or region with a focus on reducing the burden and consequences of kidney disease would be an important step towards achieving kidney health equity.

The Brazillian version of the hand mobility in scleroderma (HAMIS) test: translation and validation

Abstract Background: The Hand Mobility in Scleroderma (HAMIS) test was created to measure the degree of dysfunction of hand movements imposed by systemic sclerosis (SSc). The modified version (mHAMIS), with 4 of the 9 original items, was developed later. The goal of the present study was to translate and validate HAMIS and mHAMIS into Brazilian Portuguese and culture. Methods: After direct and reverse translation and comprehension test in 10 SSc patients, HAMIS-Br was applied to another 32 patients with SSc. To evaluate internal consistency, intraobserver and interobserver agreement, and intraobserver and interobserver reliability, we used respectively the Cronbach's α coefficient, kappa concordance and intraclass correlation (ICC). The correlation between HAMIS-Br and mHAMIS-Br was evaluated and a factorial analysis was performed. Results: HAMIS-Br showed excellent internal consistency (Cronbach's α = 0.997), good intraobserver agreement (kappa between 0.78 [95%CI =0.57-0.99] and 1) and intraobserver and interobserver reliability (ICC = 0.993, 95% CI = 0.973-0.993 and ICC = 0.994, 95% CI = 0.987-0.997, respectively). The mHAMIS-Br presented similar results and excellent correlation with HAMIS-Br (r = 0.923). The factorial analysis extracted three groups of questions that explain 84.4% of the total variance, and that can be understood through the influence of certain movements in the interpretation of others: [1] questions whose interpretation is influenced by the extension of the fingers, [2] questions whose interpretation is influenced by flexion of the fingers, [3] volar flexion of the fingers, with similar correlation with both other factors. Conclusions: HAMIS-Br and mHAMIS-Br showed good agreement, intraobserver and interobserver reliability, and internal validity. It is necessary to be attentive to the influence of certain limitations of movements in the interpretation of others.

Use of technological tools to evaluate handwriting production of the alphabet and pseudocharacters by Brazilian students

OBJECTIVE: This study aimed to characterize and compare the handwriting performance of Brazilian students from the 3rd to the 5th grade level of elementary school I with a computerized instrument that allowed the real performance to be observed during the execution of the handwriting. METHODS: Ninety-five students, aged 8 years to 11 years and 11 months, were assigned the production tasks of handwriting letters and pseudocharacters to assess the variables of latency, letter duration production and movement fluency. The stimulus presentation and the analysis of the movements were analyzed by Ductus software. RESULTS: In relation to the writing duration, latency and fluency of the alphabet letters, there was a diminution of values from the 3rd to 5th grade. For the comparison between alphabet and pseudocharacter latency, the results indicated a difference between the alphabet letter and its corresponding pseudocharacter, with greater latency for the pseudocharacter. This finding suggests that a motor sequence has not been established, so it cannot be assumed that the production of the alphabet letters was automatic. CONCLUSION: The results of this study make it possible to verify the interaction failures between the central and peripheral processes, with progression between the 3rd and 5th grade. It also highlights the influence of the lack of systematized teaching of the tracing of letters for Brazilian students since proficiency in calligraphy is critically linked to academic performance. These findings provide a great contribution to Brazilian educational psychology and reflect both educational and clinical practices.

Application of 3D Electromagnetic Articulography in Dentistry: Mastication and Deglutition Analysis. Protocol Report / Aplicación de la Articulografía Electromagnética 3D en Odontología: Análisis de la Masticación y Deglución. Reporte de Protocolo

ABSTRACT: The Stomatognathic System (SS) is an integrated and coordinated morphofunctional unit, consisting of skeletal, muscular, angiological, nervous, glandular and dental structures that work in harmony to perform different functions such as chewing, swallowing, speaking, breathing, tasting and esthetics. The study of SS physiology is crucial to achieving a correct maintenance of its normal function or restoration. Thus, we developed a protocol to record mandibular movement, chewing and swallowing (saliva and water) by using the 3D-electromagnetic articulograph AG501 at the Oral Physiology Laboratory of the Research Centre for Dental Sciences (CICO). This tool has been used for decades in speech and phonetic research and it is able to record, present and evaluate articulated structure movement data in real time. The articulograph provides an ordered data matrix (values ??for the x, y, z axes, among others) for the recorded movement, which is stored in binary files that can be processed by different software. One of these is MATLAB®, allowing us to perform a quick, clear and understandable analysis. The existence of a standardized methodology for recording allows an accurate description of the stages to perform different types of measurements according to the researcher's objective. This has opened the way for a new type of oral physiology analysis based on study reproducibility, which is considered one of the bases of scientific methodology.

RESUMEN: El Sistema Estomatognático es una unidad morfo-funcional integrada y coordinada, constituida por estructuras esqueléticas, musculares, angiológicas, nerviosas, glandulares y dentales que actúan en armonía para realizar diferentes funciones como la masticación, deglución, fonoarticulación, respiración, degustación y estética. Es importante el estudio de la fisiología del SE para lograr un correcto mantenimiento de su función normal, o para la restauración de este. Es así como en el Laboratorio de Fisiología Oral del Centro de Investigación en Ciencias Odontológicas (CICO) hemos desarrollado un protocolo para el registro del movimiento mandibular, masticación y deglución (saliva y agua), utilizando el articulógrafo electromagnético 3D AG501, el cual ha sido utilizado desde hace décadas en la investigación del habla y la fonética y que es capaz de grabar, presentar y evaluar en tiempo real datos del movimiento de estructuras articuladas. El articulógrafo provee de una matriz de datos ordenados (valores para los ejes x, y, z, entre otros) para el movimiento registrado, el cual se almacena en archivos binarios que pueden procesarse a través de diferentes softwares. Uno de ellos es MATLAB®, el cual nos permite realizar un análisis de forma rápida, clara y comprensible. La existencia de una estandarización metodológica de registro, permite describir de forma exacta las etapas para llevar a cabo distintos tipos de mediciones según el objetivo del investigador. De esta forma se abre la puerta a una nueva forma de análisis en la fisiología oral que se sustenta en la reproducibilidad de la investigación que es considerada una de las bases de la metodología científica.

How often should sitting and rising from a chair be evaluated in patients with Duchenne muscular dystrophy? / Com que frequência deve ser avaliada a atividade de sentar e levantar da cadeira em pacientes com distrofia muscular de Duchenne?

ABSTRACT Objective To determine how often sitting/rising from a chair should be assessed in Duchenne muscular dystrophy (DMD) patients to avoid redundant/missing data. Methods Sitting/rising from a chair was evaluated in 26 DMD children (5-12 yrs), in three-month intervals, over twelve months, with the Functional Evaluation Scale (domain sitting/rising from a chair). Scores were compared by effect sizes (ES) and standardized response means (SRM) (responsiveness analysis). Results Sit-to-stand showed low-to-moderate responsiveness in three-month intervals (ES:0.23-0.32; SRM:0.36-0.68), moderate-to-high responsiveness in six-month intervals (ES:0.52-0.65; SRM:0.76-1.28), high responsiveness at nine-month (ES:0.84-0.91; SRM:1.26-1.64) and twelve-month intervals (ES:1.27; SRM:1.48). Stand-to-sit showed low responsiveness in three-month intervals (ES:0.26-0.49; SRM:0.37-0.42), moderate responsiveness in six-month intervals (ES:0.50-0.78; SRM:0.56-0.71), high responsiveness in nine-month (ES:0.94-1.00; SRM:0.84-1.02) and twelve-month intervals (ES:1.13; SRM:1.52). Conclusion Six months or longer intervals for reassessment are indicated to evaluate sitting/standing from a chair in DMD patients.

RESUMO Objetivo Determinar a frequência de avaliação do sentar e levantar da cadeira em pacientes com distrofia muscular de Duchenne (DMD), para evitar informações faltantes ou redundantes. Métodos Sentar/ Levantar foram avaliados em 26 crianças com DMD (5-12 anos), em intervalos de três meses, durante doze meses, com a Escala de Avaliação Funcional (domínio sentar/ levantar da cadeira). Os tamanhos do efeito (TE) e as médias de resposta padronizada (MRP) foram usados na análise de responsividade. Resultados Levantar da cadeira teve responsividade baixa a moderada em três meses (TE: 0,23-0,32; MRP: 0,36-0,68), moderada a alta em seis meses (TE: 0,52-0,65; MRP: 0,76-1,28), alta em nove e (TE: 0,84-0,91; MRP: 1,26-1,64) doze meses (TE: 1,27; MRP: 1,48). Sentar na cadeira teve responsividade baixa em três meses (TE: 0,26-0,49; MRP: 0,37-0,42), moderada em seis meses (TE: 0,50-0,78; MRP: 0,56-0,71), alta em nove (TE: 0,94-1,00; MRP: 0,84-1,02) e doze meses (TE: 1,13; MRP: 1,52). Conclusão Os pacientes com DMD devem ser reavaliados com intervalos mínimos de seis meses entre avaliações de sentar/ levantar da cadeira.

Bereitschaftspotential preceding eyelid blinks in Parkinson's disease / Potencial de Bereitschafts precedendo o piscamento ocular na doença de Parkinson

ABSTRACT The Bereitschaftspotential (BP) is a negative wave observed in EEG retrograde averaging, preceding a motor act. The objective was to study the BP preceding voluntary eyelid blinks in Parkinson's disease (PD) patients during off and on phases of levodopa. Methods Ten PD patients in stages 1 and 2 of the Hoehn & Yahr classification were compared to 18 healthy controls. Artifact-free EEG segments of two seconds preceding the onset of the blink potential were averaged and analyzed, and the statistical significance of the measured amplitudes were evaluated by analysis of variance models. Results The presence of a BP in the PD patients was demonstrated. The mean amplitudes at 0 ms were respectively 0.6 µV and 3.3 µV for the BP patients and the normal controls, respectively. Conclusions The BP amplitudes were significantly smaller in PD patients than normal participants. The amplitudes of the BP were not modified by levodopa.

RESUMO O Potencial de Bereitschafts (PB) é uma onda negativa observada retrogradamente no EEG precedendo um ato motor. Objetivo Estudar o PB precedendo o piscamento palpebral voluntário em pacientes com doença de Parkinson (DP) durante as fases off e on da levodopa. Foram comparados dez pacientes com DP nos estágios 1 e 2 de Hoehn & Yahr com 18 controles saudáveis. Os segmentos de EEG livres de artefatos 2 segundos antes do início do potencial foram calculados e analisados e a significância estatística das amplitudes foi medida por modelos de análise de variância. Resultados A presença de PB nos pacientes com DP foi demonstrada. As amplitudes médias a 0 ms foram respectivamente 0,6 μV e 3,3 μV para os pacientes com DP e controles respectivamente. Conclusões As amplitudes do PB foram significativamente menores nos pacientes com DP do que controles. As amplitudes do PB não foram modificadas pela levodopa.

Evaluation of static and dynamic balance in athletes with anterior cruciate ligament injury – A controlled study

OBJECTIVES: Anterior cruciate ligament injury leads to adaptive responses to maintain postural control. However, there is no consensus regarding whether leg dominance also affects postural control in athletes with anterior cruciate ligament injury. The purpose of this study was to evaluate dynamic and static postural control among athletes with and without anterior cruciate ligament injury to the dominant leg. METHODS: Twenty-eight athletes, twenty-one males and seven females aged 15-45 years, were allocated to one of two groups: the anterior cruciate ligament injury group (26±3 years) or the control group without anterior cruciate ligament injury (25±6.5 years). All subjects performed one legged stance tests under eyes open and eyes closed conditions and squat and kick movement tests using a postural control protocol (AccuSwayPlus force platform, Massachusetts). The center of pressure displacement and speed were measured by the force platform. In addition, the distance traveled on the single-leg hop test was assessed as an objective measure of function. RESULTS: Significantly greater mediolateral sway was found under the eyes closed condition (p=0.04) and during squat movement (p=0.01) in the anterior cruciate ligament injury group than in the control group. Analysis of the single-leg hop test results showed no difference between the groups (p=0.73). CONCLUSION: Athletes with anterior cruciate ligament injury had greater mediolateral displacement of the center of pressure toward the dominant leg under the eyes closed condition and during squat movement compared to control athletes.

Postural instability and falls are more frequent in Parkinson's disease patients with worse trunk mobility / Instabilidade postural e quedas são mais frequentes em pacientes com doença de Parkinson com pior mobilidade de tronco

ABSTRACT Postural instability and axial rigidity are frequent symptoms of the Parkinson’s disease (PD). Objective Correlate the occurrence of falls and the activity of rolling over in bed with performance on the Trunk Mobility Scale (TMS) in patients with PD, and determine whether this instrument score can predict the risk of falls. Method This is a cross-sectional study. Assessed patients reported the frequency of falls in the previous year and whether they had difficulties rolling over in bed. Then, the following scales were applied: TMS, Hoehn and Yahr, Unified Parkinson’s Disease Rating Scale-III and Schwab and England Activities of Daily Living. Results Eighty-five patients were analyzed. Patients with a history of falling showed worse performance in the TMS (p < 0.01). There is a significant correlation between TMS and the activity of rolling over in bed (p < 0.01). Conclusion PD fallers present worse scores in TMS, and there is a significant correlation between difficulty rolling over in bed and TMS score.

RESUMO A instabilidade postural e a rigidez axial são sintomas frequentes da doença de Parkinson (DP). Objetivo Correlacionar a ocorrência de quedas e a atividade de rolar na cama com o desempenho na Escala de Mobilidade de Tronco (TMS) entre os pacientes com DP e verificar se esse instrumento pode prever o risco de quedas. Metodo Trata-se de um estudo transversal onde os pacientes avaliados relataram a frequência de quedas no ano anterior e as suas dificuldades para rolar na cama. Em seguida as seguintes escalas foram aplicadas: TMS, Hoehn and Yahr, Escala Unificada da Doença de Parkinson-III e Escala Schwab e England. Resultados 85 pacientes foram avaliados. Os pacientes que possuíam histórico de quedas apresentaram pior desempenho no TMS (p < 0,01). Há uma correlação significativa entre a TMS e a atividade de rolar na cama (p < 0,01). Conclusão Pacientes que relataram quedas apresentam pior pontuação no TMS e há uma correlação significativa entre a dificuldade de rolar na cama e o TMS.

Median nerve location change evaluated by soft cadaver dissection according to the forearm movement / Cambio de posición del nervio mediano evaluado mediante disección cadavérica blanda según el movimiento del antebrazo

The aim of this study was to examine the change in median nerve location according to forearm movement. Thirty fresh specimens from 15 adult Korean cadavers (10 males and five females; age range, 53­91 years) were examined. We measured the motor entry point according to normal and pronated positions of the forearm. The x and y coordinates of the first motor entry point (MEP) in the normal position were 1.6±0.6 cm and 2.8±1.3 cm, respectively. The depth of the MEP was 1.5±0.3 cm. The x and y coordinates of the second MEP were 1.3±0.3 cm and 4.7±1.7 cm, respectively. The depth of the MEP was 1.4±0.2 cm. The x and y coordinates of first MEP with the forearm in the pronated position were 1.9±0.7 cm and 2.3±0.8 cm. respectively. The depth of the MEP was 1.7±0.4 cm. The x and y coordinates of the second MEP were 1.6±0.7 cm and 4.4±1.7 cm, respectively. The depth of the MEP was 1.6±0.3 cm. The differences in locations according to movement of the nerve branch were 0.3 cm, and depths were 0.2 cm. The pronated position results of this study will be clinically helpful.

El objetivo fue examinar el cambio de posición del nervio mediano de acuerdo con el movimiento del antebrazo. Se examinaron 30 muestras frescas de 15 cadáveres adultos coreanos (10 hombres y 5 mujeres) con edades entre 53­91 años. Se midió el punto de entrada motor de acuerdo con las posiciones normales y pronación del antebrazo. Las coordenadas X e Y del primer punto de entrada motor (PEM) en la posición normal fueron de 1,6±0,6 cm y 2,8±1,3 cm, respectivamente. La profundidad del PEM fue de 1,5±0,3 cm. Las coordenadas X e Y del segundo PEM fueron 1,3±0,3 cm y 4,7±1,7 cm, respectivamente. La profundidad del PEM fue 1,4±0,2 cm. Las coordenadas X e Y del primer PEM del antebrazo en posición de pronación fueron 1,9±0,7 cm y 2,3±0,8 cm, respectivamente. La profundidad del PEM fue 1,7±0,4 cm. Las coordenadas X e Y del segundo PEM fueron 1,6±0,7 cm y 4,4±1,7 cm, respectivamente. La profundidad del PEM fue 1,6±0,3 cm. Las diferencias en las ubicaciones de acuerdo con el movimiento del ramo nervioso fueron de 0,3 cm, y las profundidades fueron de 0,2 cm. Los resultados de la posición de pronación de este estudio serán útiles en trabajos clínicos.

Do code of points in men artistic gymnastics and women artistic gymnastics favor asymmetric elements? / O código de pontuação na ginástica artística feminina e masculina favorecem elementos assimétricos?

Abstract The purpose of research was to determine whether Code of Point (COP) in Men Artistic Gymnastics (MAG) and Women Artistic Gymnastics (WAG) favor asymmetric elements in order to build gymnast’s competition exercise. All elements which are described in MAG (N = 993) and WAG (N = 713) COP were included and defined if they are symmetric at start position, during movement and at final position. Element is symmetric by arms and trunk with legs activity when all left and right body side performs simultaneously same activity. Results show in MAG COP as a whole is significantly more asymmetric elements with asymmetric trunk and legs activity. In WAG COP as a whole is significantly more asymmetric elements with asymmetric activity of arms, trunk and legs. Hypothetical most difficulty exercises on each apparatus revealed that in general for all around gymnast proportion between asymmetric and symmetric elements is close to 70% to 30%, what suggests that difficulty relates to increased asymmetry. COP in MAG and WAG enforces asymmetric movements for achieving high results, however, coaches’ task is to be aware of COP influence on gymnasts’ health and minimize asymmetries in load and to work on symmetric conditioning.

Resumo A pesquisa investigou se o Código de Pontuação (COP) da Ginástica Artística Masculina (MAG) e da Ginástica Artística Feminina (WAG) favoreciam elementos assimétricos, a fim de arquitetar elementos competitivos do ginasta. Todos os elementos descritos no COP da MAG (N = 993) e WAG (N = 713) foram analisados em suas posições de início, durante a na posição final no que se refere à simetria. Foram considerados simétricos os movimentos em que braços, troncos e pernas eram ativados simultaneamente e do mesmo lado. Os resultados mostraram que no COP MAG há um número significativamente maior de elementos assimétricos, sobretudo na relação tronco e pernas. No COP WAG há um maior número de elementos assimétricos entre braços, tronco e pernas. Hipoteticamemte, os exercícios com maior dificuldade em cada um dos aparelhos revelaram que a proporção entre elementos assimétricos e simétricos é de cerca de 70% e 30% respectivamente, o que releva que a dificuldade está associada com maior assimetria. O COP na MAG e WAG reforçam que realizar movimento assimétricos amplia o grau de dificuldade e elevados resultados, no entanto, os técnicos devem se atentar ao COP e sua influência no bem-estar dos ginastas, minimizando cargas assimetrias e trabalhado em condicionamento simétric.