Water- versus land-based treatment for postural control in postmenopausal osteoporotic women: a randomized, controlled trial.

OBJECTIVE: To compare the effects of water-based and land-based physical therapy on postural control of older women with osteoporosis. METHODS: Thirty-six postmenopausal women with osteoporosis were allocated into two groups: land-based or water-based. Volunteers received 12 weeks of a supervised land-based or water-based physical therapy treatment. The outcome measure was postural control of the body during quiet standing on upright stance (eyes opened and closed), tandem and one-limb stance on a force plate. A two-way ANOVA with a Tukey HSD post-hoc test were used to highlight differences between pre- and post-intervention evaluations. Effect sizes were measured with Cohen d coefficient. For all variables, a level of 5% of significance was adopted. RESULTS: Significant improvements at tandem (p < 0.05, effect sizes from -0.67 to -1.35) and one-limb stance (p < 0.05, effect sizes from -0.76 to -1.03) for women carrying out water-based treatment were observed. Land-based treatment did not present significant improvement. CONCLUSIONS: Group-based water-based physical therapy treatment may be more effective than land-based therapy to improve postural control at one-limb stance in women with osteoporosis.

Identifying Frailty Levels and Associated Factors in a Population Living in the Context of Poverty and Social Vulnerability.

This study aimed to investigate a vulnerable population living in the context of poverty in a Brazilian municipality, in order to identify the factors that are associated with frailty syndrome in elderly people. From the total population living in the area, a random sample of 363 community-dwelling people, 60 years and older, age and gender-stratified, was selected to participate in the research. After losses, a sample of 304 older adults was classified as non-frail, pre-frail and frail. According to the Fried frailty criteria, the prevalence was 12.2% for non-frail individuals, 60.5% pre-frail and 27.3% frail. The main factors associated with frailty in the studied sample were low level of physical activity (OR: 5.2, 95%CI: 2.5-11.0), the occurrence of two or more falls within 12 months (OR: 3.1, 95%CI: 1.4-7.1), mobility deficits (OR: 3.0, 95%CI: 1.5-5.8), and depressive symptoms (OR: 1.9, 95%CI: 1.1-3.7). This study identified the most important factors that must be evaluated to identify frailty syndrome in a socially vulnerable population in the context of poverty. The data should help to encourage effective strategies concerning public health policies for this population.

Measuring postural control during mini-squat posture in men with early knee osteoarthritis.

Studies have suggested a compromised postural control in individuals with knee osteoarthritis (OA) evidenced by larger and faster displacement of center of pressure (COP). However, quantification of postural control in the mini-squat posture performed by patients with early knee OA and its relation to muscle strength and self-reported symptoms have not been investigated. The main aim of this cross-sectional, observational, controlled study was to determine whether postural control in the mini-squat posture differs between individuals with early knee OA and a control group (CG) and verify the relation among knee extensor torque (KET) and self-reported physical function, stiffness and pain. Twenty four individuals with knee OA grades I and II (OAG) (mean age: 52.35±5.00) and twenty subjects without knee injuries (CG) (mean age: 51.40±8.07) participated in this study. Participants were assessed in postural control through a force plate (Bertec Mod. USA), which provided information about the anterior-posterior (AP) and medial-lateral (ML) COP displacement during the mini-squat, in isometric, concentric and eccentric knee extensor torque (KET) (90°/s) through an isokinetic dynamometer (BiodexMulti-Joint System3, Biodex Medical Incorporation, New York, NY, USA), and in self-reported symptoms through the WOMAC questionnaire. The main outcomes measured were the AP and ML COP amplitude and velocity of displacement; isometric, concentric, and eccentric KET and self-reported physical function, stiffness and pain. No significant differences were found between groups for postural control (p>0.05). Significant lower eccentric KET (p=0.01) and higher scores for the WOMAC subscales of pain (p=<0.001), stiffness (p=0.001) and physical function (p<0.001) were found for the OAG. Moderate and negative correlations were found between the AP COP amplitude of displacement and physical function (ρ=-0.40, p=0.02). Moderate and negative correlations were observed between the AP COP velocity of displacement and physical function (ρ=0.47, p=0.01) and stiffness (ρ=-0.45, p=0.02). The findings of the present study emphasize the importance of rehabilitation from the early degrees of knee OA to prevent postural instability and the need to include quadriceps muscle strengthening, especially by eccentric contractions. The relationship between the self-reported symptoms and a lower and slower COP displacement suggest that the postural control strategy during tasks with a semi-flexed knee should be further investigated.

Efeito da rotação do quadril na sindrome da dor femoropatelar / Effect of hip rotation on patellofemoral pain syndrome

A proposta deste trabalho foi investigar o efeito da rotacao do quadril na atividade eletrica dos musculos Vasto Medial Obliquo (VMO). Vasto Lateral Obliquo (VLO) e Vasto Lateral Longo (VLL) no agachamento a 45o. de flexao do joelho associado a posicao neutra, rotacao laterala 45o. e rotacao medial a 15 e 30o. de quaril. Materiais e metodos: foram avaliadas 27 mulheres, sendo 15 mulheres normais do grupo controle (21,1+-2,1 anos) e 12 portadoras de sindrome da Dor Femoropatelar (SDFP) (21,0+-2,3 anos). A atividade eletrica do musculo quadriceps foi captada opr eletrodos ativos diferenciais simples de superficie, eletromiografo de 8 canais e programa Aqdados 7.2.6. Os dados foram normalizados pela porcentagem da media do agachamento a 75o. com o quadril em posicao neutra - RMS (uV). A analise estatistica utilizada foi ANOVA two way com medidas repetidas e Turkey pos hoc (p<-0,05). Resultados: os resultados evidenciaram interacao entre grupos e musculos (p=0,00), independente da posicao do quadril (p=0,39) e nao houve interacao entre grupos e posicoes do quadril (p=0,96). Os musculos VMO e VLL do grupo SDFP apresentaram atividade eletrica significativamente maior que o VMO (p=0,00) e VLL (p=0,04) do grupo controle. Por outro lado, a atividade eletrica do musculo VLO nao apresentou diferenca significativa entre os grupos (p=0,99). Conclusao: os resultados dessa pesquisa, nas condicoes experimentais utilizadas, sugerem que a rotacao do quadril nao influenciou a atividade eletrica das porcoes do quadriceps nos dois grupos no agachamento a 45o. de flexao do joelho