Design de produtos assistivos para idosos / Design of assistive products for the elderly

A promoção de condições para a vida independente é, possivelmente, um dos maiores desafios decorrentes do fenômeno mundial de envelhecimento populacional. Para as áreas de projeto e desenvolvimento de produtos, este contexto implica em pensar novos produtos que atendam às características, necessidades e preferências desta população. Na prática, o desafio é desenvolver produtos cujas demandas para o uso sejam diminuídas, o que resulta na facilitação do uso para uma maior diversidade de usuários. Estas demandas compreendem as habilidades ­ físicas, sensoriais e cognitivas ­ que o uso de um determinado produto exige do usuário para um desempenho satisfatório. Considerando o declínio funcional natural que decorre do processo de envelhecimento com alterações como diminuição da força muscular, flexibilidade e controle postural, assim como diminuição da acuidade visual, a pessoa idosa pode vir a ter dificuldades no uso de produtos cujas demandas sejam elevadas. Conhecer de que forma as alterações fisiológicas do processo de envelhecimento influenciam as habilidades físicas, cognitivas e sensoriais do idoso é, portanto, fundamental para o sucesso no processo de design para produtos pensados para o público idoso. Especificamente, no caso de produtos de Tecnologia Assistiva, os aspectos simbólicos são importantes, pois remetem ao significado do produto para o usuário e podem influenciar a aceitação e engajamento ao uso destes dispositivos. É, portanto, necessário que o design de produtos assistivos para o público idoso busque não somente atender as questões funcionais, mas também conceber produtos atrativos e desejáveis.(AU)

The promotion of conditions for independent living is possibly one of the biggest challenges arising from the worldwide phenomenon of population aging. In the context of product design and development, this implies thinking about new products that meet the characteristics, needs and preferences of this population. In practice, the challenge is to develop products whose usage demands are reduced, which results in facilitating use for a greater diversity of users. These demands include the skills - physical, sensory and cogni- tive - that the use of a particular product requires from the user for satisfactory performance. Considering the natural functional decline that results from the aging process with changes such as decreased muscle strength, flexibility and body balance, as well as decreased visual acuity, the elderly may have difficulties in using products whose demands for use are high. Knowing how the physiological changes of the aging process influence the physical, cognitive and sensory skills of the elderly is, therefore, fundamental to the success in the design process for products designed for the elderly. Specifically, in the case of Assistive Technology products, the symbolic aspects are important as they refer to the meaning of the product to the user and may influence the acceptance and engagement to the use of these devices. It is, therefore, necessary that the design of assistive products for the elderly seeks not only to address functional issues, but also to design attractive and desirable products.(AU)

Propulsion efficiency in wheelchair tennis: a case study on the influence of the racket on the handrim forces

Aims: to evaluate how the act of holding a tennis racket influences the application of forces in the handrim during manual wheelchair propulsion at a self-selected comfortable speed and sprint. Methods: A case study was conducted with an experienced wheelchair tennis player who propelled the wheelchair in a straightforward trajectory at two different velocities (self-selected comfortable speed and sprint) in two different conditions (freehand and holding the racket). Kinetic and temporal data of the pushes were obtained with the SmartWheel system attached in substitution to the conventional rear wheel at the dominant side of the player. Results: holding the racket affects the propulsion pattern mainly when an accelerated movement is required (sprint). Compared to the propulsion at a self-selected speed, propelling the chair as fast as possible with the racket in hands resulted in lower total and tangential forces on the handrim, and decreased push time and increased push frequency. Conclusion: Such influence on both kinetic and temporal propulsion impact the mechanical efficiency of the manual wheelchair propulsion, which may, ultimately, affect the sport´s performance. Special attention should be directed to the propulsion training with the racket in maneuvers and motions that are characteristic of the wheelchair tennis match in an attempt to provide the athlete with proper technique for optimal propulsion efficiency and sports performance.(AU)

Postural balance in Alzheimer's disease patients undergoing sensory pitfalls

Despite consensus regarding the interference of cognitive processes on the human balance, the impact that different sensory stimuli have on the stabilometric measures remains unclear. Here, we investigated changes in the postural balance of individuals with Alzheimer's disease (AD) and in healthy controls undergoing different proprioceptive and somesthetic pitfalls. We included 17 subjects submitted to eight sensorimotor dynamics with differences in the support bases, contact surfaces, and visual clues. The measurements used to assess participants balance were as follows: position of the body in space, range of instability, area of the support base, and velocity of postural control. From a total of 56 cross-sectional analyses, 21.42% pointed out differences between groups. Longitudinal analyses showed that tasks with proprioceptive and somesthetic pitfalls similarly impact imbalance in both groups. The current results suggest that AD subjects and healthy controls had different patterns submitted to balance, but suffered similar interference when undergoing proprioceptive and somesthetic challenges

O esporte na qualidade de vida de indivíduos com lesão da medula espinhal: série de casos / Sports on quality of life of individuals with spinal cord injury: a case series

INTRODUÇÃO: A lesão da medula espinhal é um trauma de impacto físico e social ao indivíduo, que acarreta profundas modificações na vida de seus portadores pela paraplegia ou tetraplegia resultante. O objetivo deste estudo foi avaliar a percepção da qualidade de vida de indivíduos com lesão da medula espinhal, antes e após um período de treinamento esportivo. MÉTODOS: Participaram do estudo 16 indivíduos paraplégicos por lesão da medula espinhal, que realizaram treinamento esportivo da modalidade basquetebol em cadeira de rodas, com duração de duas horas por dia e frequência de duas vezes por semana, por um período de um ano. Para avaliação da qualidade de vida PRÉ e PÓS o período de treinamento, foi utilizado o questionário SF-36. RESULTADOS: Houve melhora geral na qualidade de vida (p = 0,006) dos participantes quando considerados os escores de todos os domínios do questionário somados PRÉ (605,7) e PÓS (651,9) treinamento. Ainda, analisando de forma específica, foi observada melhora com significância estatística na capacidade funcional (p = 0,004), estado geral de saúde (p = 0,001) e aspectos emocionais (p = 0,02). CONCLUSÃO: O treinamento esportivo mostrou-se benéfico, promove melhora na qualidade de vida de pessoas com lesão da medula espinhal que necessitam de cadeira de rodas para mobilidade e representa novos objetivos e desafios na continuidade no processo de reabilitação.

INTRODUCTION AND OBJECTIVE: The spinal cord injury is a trauma of physical and social impact to the individual, which causes profound changes in the lives of those affected by the resultant paraplegia or quadriplegia. The aim of this study was to evaluate the perception of quality of life of individuals with spinal cord injury before and after a period of sport training. METHODS: The study included 16 people with paraplegia by spinal cord injury, who underwent sports training of basketball in wheelchairs, with a frequency of 2 times per week for a period of 1 year. To assess the quality of life before and after the training period, we used the SF-36. RESULTS: There was overall improvement in quality of life (p = 0.006) when considering the average of all areas of the questionnaire combined scores PRE (605.7) and POST (651.9) training. Additionally, the analysis of the results showed statistically significant improvement in functional capacity (p = 0.004), general health (p = 0.001) and emotional aspects (p = 0.02). CONCLUSION: The sport can promote improvement in quality of life for people who need a wheelchair for mobility, and represents new goals and challenges in continuing the process of rehabilitation.

Efeito da tração manual sobre o comprimento da coluna cervical em indivíduos assintomáticos: estudo randomizado controlado / The effect of manual traction on the length of cervical spine in asymptomatic individuals: a randomized controlled study

Os objetivos do estudo foram o de mensurar o comprimento da coluna cervical quando submetida à tração manual, e o de verificar as alterações da cervical após um período de 10 sessões consecutivas. Trata-se de estudo randomizado controlado, no qual 64 participantes foram submetidos a dois procedimentos radiológicos, antes e durante a tração. As distâncias das bordas anteriores e posteriores do corpo vertebral C2 até as do corpo vertebral de C7 foram mensuradas e comparadas. Na primeira etapa as medidas das bordas anteriores foi de 8,40 para 8,50 cm (P<0,001) e nas posteriores foi de 8,35 para 8,50 cm (P<0,001). Para a segunda etapa, os indivíduos foram aleatorizados em grupo controle (n=31) e intervenção (n=33), o qual recebeu dez sessões tração cervical. Após as sessões, as distâncias anterior e posterior do grupo intervenção aumentaram significativamente de 8,40 para 8,90 cm (P<0,001) e de 8,40 para 8,65 cm (P<0,001), respectivamente. Após as trações, todos os participantes repetiram os mesmos procedimentos radiológicos, as mensurações e as comparações das distâncias vertebrais. Quando os dois grupos foram comparados após as trações, houve diferença estatisticamente significante entre as distâncias anteriores e posteriores, de 8,20 e 8,90 cm (P=0,015) e de 8,30 e 8,65cm (P=0,030), respectivamente. Portanto, a tração aumentou o comprimento da coluna cervical. Após um período de aplicação das sessões, ocorreu aumento significativo das medidas entre as vértebras.

The objectives of the study were to measure the length of the cervical spine when submitted to manual traction and to verify changes in the cervical spine after 10 consecutive sessions. In this randomized controlled study 64 participants were submitted to two radiological procedures: one before and another during traction. The distances between the anterior and posterior vertebrae edges of C2 the C7 were measured and compared. In the first stage it was shown that measures of the anterior distance was 8.40 to 8.50 cm (P<0.001) and the posterior was 8.35 to 8.50 cm (P<0.001). For the second stage, subjects were randomized in control group (n=31) and intervention group (n=33) which received ten sessions of cervical traction. After the sessions the anterior and posterior distances of the intervention group increased significantly from 8.40 to 8.90 cm (P<0.001) and 8.40 to 8.65 cm (P<0.001) respectively. After the sessions all participants repeated the same radiological procedures, measurements and comparisons of the vertebral distance. When the groups were compared after the sessions there were statistically significant differences between the anterior and posterior distance of 8.20 and 8.90 cm (P=0.015) and 8.30 and 8.65 (P=0.030) respectively. Therefore the traction increased the length of the cervical spine and after a period of application of this intervention there was significant increase of the measures between the vertebral distances.

Análise radiográfica da coluna cervical em indivíduos assintomáticos submetidos a tração manual / Radiographic analysis of the cervical spine in healthy individuals submitted to manual traction

OBJETIVO: Avaliar, radiograficamente, o efeito da tração manual sobre o comprimento da coluna cervical. MATERIAIS E MÉTODOS: Cinqüenta e cinco participantes de ambos os gêneros - 12 masculinos (22 por cento) e 43 femininos (78 por cento) - sem história de distúrbios cervicais contituíram a amostra deste estudo. Eles foram submetidos a dois procedimentos radiológicos, um antes e outro durante a tração manual sustentada por 120 segundos. As distâncias entre as bordas anteriores e posteriores da segunda à sétima vértebras cervicais foram mensuradas e comparadas antes e durante a tração manual. RESULTADOS: A mediana da distância anterior antes da tração foi de 8,40 cm e durante a tração aumentou para 8,50 cm (p=0,002). A mediana da distância posterior antes da tração foi de 8,35 cm e durante a tração aumentou para 8,50 cm (p<0,001). CONCLUSÃO: Os resultados demonstraram que a aplicação da tração manual promoveu aumento estatisticamente significante do comprimento da coluna cervical em indivíduos assintomáticos.

OBJECTIVE: To evaluate radiographically the effect of manual traction on the length of the cervical spine in healthy individuals. MATERIALS AND METHODS: The sample of the present study included 55 individuals - 12 men (22 percent) and 43 women (78 percent) - with no previous history of cervical disorders, submitted to two radiological procedures previously and during manual traction sustained for 120 seconds. Distances between the anterior and posterior edges from the second to the seventh cervical vertebrae were measured and compared before and during manual traction. RESULTS: The median of pre-traction anterior length was 8.40 cm, increasing to 8.50 cm during the traction (p=0.002); and the median of pre-traction posterior length was 8.35 cm, increasing to 8.50 cm during traction (p<0.001). CONCLUSION: Application of manual traction resulted in a statistically significant increase in the length the cervical spine in healthy individuals.