Reference values and equations reference of balance for children of 8 to 12 years.

PURPOSE: There are still no normative data in balance sway for school-age children in Brazil. We aimed to establish the reference ranges for balance scores and to develop prediction equations for estimation of balance scores in children aged 8 to 12 years old. METHODS: The study included 165 healthy children (83 boys and 82 girls; age, 8-12 years) recruited from a public school in the city of Florianópolis, Santa Catarina, Brazil. We used the Sensory Organization Test to assess the balance scores and both a digital scale and a stadiometer to measure the anthropometric variables. We tested a stepwise multiple-regression model with sex, height, weight, and mid-thigh circumference of the dominant leg as predictors of the balance score. RESULTS: For all experimental conditions, girls' age accounted for over 85% of the variability in balance scores; while, boys' age accounted only 55% of the variability in balance scores. Therefore, balance scores increase with age for boys and girls. CONCLUSION: This study described the ranges of age- and sex-specific normative values for balance scores in children during 6 different testing conditions established by the sensory organization test. We confirmed that age was the predictor that best explained the variability in balance scores in children between 8 and 12 years old. This study stimulates a new and more comprehensive study to estimate balance scores from prediction equations for overall Brazilian pediatric population.

The influence of seat heights and foot placement positions on postural control in children with cerebral palsy during a sit-to-stand task.

This paper aimed to analyze, from both a kinetic and kinematic perspective, the postural control of children with cerebral palsy (CP) able to independently perform the sit-to-stand (STS) task (ICP) and children who needed support (SCP) typically developing children during the STS; and also investigate the influence of seats heights and foot placement positions on postural control of these children. Fourteen children with CP and fourteen typically developing controls were recruited. Based on the Gross Motor Function Classification System (GMFCS) the children with CP were divided into ICP (level I) and SCP (levels II and III). Balance was assessed using the Pediatric Balance Scale. Motor function was rated using the GMFCS. Kinematic and kinetic data were recorded and analyzed during the STS task at two different seat heights and foot placement positions. The SCP exhibited significantly less balance according to the PBS and smaller displacement of their center of pressure (COP) in anteroposterior (COPAP) and mediolateral (COPML) direction relative to the other two groups. ICP demonstrated significant greater in the COPML displacement than the other groups. Children with CP required more time to complete the STS than controls. Those in the SCP group had lower linear displacement of the shoulder and knee than others during the STS task. During the high bench condition, the linear displacements of the shoulder and knee were reduced also. We conclude that the SCP has less COPAP and COPML oscillation, what means the better postural control during STS than the other two groups, which may be related to the support provided. The ICP exhibited greater COPML oscillations than controls, suggesting that they utilized different strategies in the frontal plane during the STS task. The seat height and foot placement did not influence postural control in children with CP, at least in terms of kinetic parameters. Seat height influenced the kinematic variables, with a high bench reducing linear displacement of the shoulder (vertical and horizontal) and knee (vertical) both in children with CP and control children.

Usando um acelerômetro para analisar o movimento de alcance e e preensão após o AVE / El uso de un acelerómetro para analizar un movimiento de alcance i e preensão después del accidente cerebrovascular / Using an accelerometer for analyzing a reach-to-grasp movement after stroke

The purpose of this study was using an accelerometer to access the kinematics of reach-to-grasp movements in subjects with hemiparesis. Eight subjects (59.4 ± 6.9 years old) with chronic hemiparesis (50.9 ± 25.8 months post-stroke) participated in this study. Kinematic assessment was performed using a triaxial accelerometer (EMG Systems, Brazil) attached to the subjects' forearm. Ten reach-to-grasp movements of grabbing a 500ml-size bottle were performed by the subjects with the paretic and the non-paretic upper limbs (ULs). The following space-temporal variables were calculated and used to compare the paretic and non-paretic ULs: movement time (MT), time to reach the peak velocity, absolute and relative (TPV and TPV%MT), relative deceleration duration (DEC%MT), time to peak acceleration (TPA) and peak hand acceleration (PA). Movements were slower in the paretic UL with increased MT, TPA and DEC. The accelerometer allowed to identify of changes in reaching-to-grasp movements of subjects with hemiparesis. When complex systems are not available, accelerometers can be an alternative to measure UL movements.

O objetivo deste estudo foi usar um acelerometro para avaliar a cinemática do movimento de alcance e preensão de indivíduos com hemiparesia. Participaram deste estudo oito indivíduos (59,4 ± 6,9 anos) com hemiparesia crônica (50,9 ± 25,8 meses pós-AVE). A avaliação cinemática foi realizada através de acelerômetro triaxial (EMG Systems do Brasil) fixado no antebraço. Os indivíduos realizaram 10 movimentos de alcançar uma garrafa de 500 ml pelo membro superior (MS) parético e não parético. As seguintes variáveis espaço-temporais foram calculadas e utilizadas para comparar o MS parético e não parético: tempo de movimento (TM), tempo para alcançar o pico de velocidade, absoluto e relativo (TPV e TPV%TM), duração relativa da desaceleração(DEC%TM), tempo para alcançar o pico de aceleração (TPA) e pico de aceleração da mão (PA). Os movimentos foram mais lentos no MS parético com maiores TM, TPA e DEC. A utilização do acelerômetro permitiu identificar alterações no movimento de alcance em indivíduos com hemiparesia. Quando sistemas mais compexos não são disponiveis, acelerometros podem ser uma alternativa para medir o movimento do MS.

El objetivo de este estudio fue analizar por acelerometría, la cinemática del movimento de alcance de los sujetos con hemiparesia. Participaron ocho individuos (59,4 ± 6,9 años) con hemiparesia crónica (50,9 ± 25,8 meses después del accidente cerebrovascular). La evaluación cinemática se realizó utilizando el acelerómetro triaxial (EMG Systems, Brasil) fijado en el antebrazo. Los sujetos realizaron10 movimientos para alcanzar una botella de 500 ml por el miembro superior (MS) parético y no parético. Las siguientes variables espacio-temporales fueron calculadas para comparar el MS parético y no parético: tiempo de movimiento (TM), tiempo para alcanzar el pico de velocidad, absoluto y relativo (TPV e TPV%TM), duración relativa de la desaceleración (DEC%TM), tiempo para alcanzar el pico de aceleración (TPA) y el pico de aceleración (PA). Los movimientos fueron más lentos en el MS parético con mayor TM, TPA y DEC. La utilización del acelerómetro permitió identificar las alteraciones en el movimiento de alcance en personas con hemiparesia. Cuando complexos sistemas no son disponibles, acelerómetros poden ser una alternativa para medir el movimiento do MS.

The effect of finger joint hypomobility on precision grip force.

STUDY DESIGN: Repeated measures experiment. INTRODUCTION: Traumatic injuries and certain other diseases of the hand typically affect mobility of the finger joints. Decreased mobility may alter grip force control while one is grasping and lifting objects. However, the effect of finger joint hypomobility on grip force control has not yet been systematically investigated. PURPOSE OF THE STUDY: The aim of this study was to investigate the effects of limited finger joint mobility, without other associated symptoms like pain, or sensory/proprioceptive deficits, on precision grip force control. METHODS: Fifteen healthy subjects performed a pinching and lifting task of an object equipped with a force sensor and an accelerometer, via opposition of the thumb and index finger, in the following experimental conditions: unrestricted finger joint movement (UJM), restricted finger flexion (RFF), restricted finger extension (RFE), mock restricted flexion (MRF), mock restricted extension (MRE). The following pinch force variables were measured and analyzed: grip force at lift off, grip force peak, load force peak, latency, and static force. RESULTS: A significant increase in latency (F = 4.41, p < 0.01) was noted during RFE relative to UJM and MRF conditions. There were no statistically-significant differences between the conditions among the other variables of precision grip force control. CONCLUSIONS: Limited joint mobility of the thumb and index finger may cause temporal changes in precision grip force control, which can lead to reduced manual dexterity. Restoring range of motion might be an important priority to improve thumb-index pinch force control during manipulative tasks.

Facilidades e habilidades do fisioterapeuta na procura, interpretação e aplicação do conhecimento científico na prática clínica: um estudo piloto / Easiness and skillfulness of physical therapists in searching, interpreting and applying scientific knowledge in clinical practice: a pilot study

INTRODUÇÃO: A procura e o interesse em aplicar conhecimento científico à prática fisioterapêutica tem crescido nos últimos anos. Na busca por integrar as experiências individuais vivenciadas na prática com a melhor evidência clínica disponível a partir de pesquisas sistemáticas, surge a Prática Baseada em Evidência (PBE), movimento científico que vem ganhando força na área da saúde. Entretanto, muito pouco se sabe se o fisioterapeuta clínico conhece e utiliza a PBE em seus atendimentos. OBJETIVO: Averiguar se os profissionais fisioterapeutas têm facilidade e habilidade em buscar literatura científica e se eles se baseiam na PBE durante sua prática clínica. MATERIAIS E MÉTODOS: Foi realizado um estudo descritivo, com abordagem quantitativa, do qual participaram 67 profissionais fisioterapeutas atuantes na região da Grande Florianópolis. Todos responderam a um questionário online adaptado a partir do Evidence-Based Practice (EBP) Questionnaire. RESULTADOS: A amostra consistiu em fisioterapeutas jovens, em uma faixa de idade entre 20 e 29 anos, havendo forte predominância do sexo feminino. Destes, 73,1% concluiu a graduação há menos de cinco anos e 71,6% não possui especialidade reconhecida pelo Crefito. Os fisioterapeutas afirmaram ter uma atitude positiva sobre PBE e estavam interessados em aprender ou aprimorar as competências necessárias para implementar PBE. Eles notaram que precisavam aumentar o uso da evidência científica em suas práticas diárias. CONCLUSÃO: A falta de tempo foi a barreira mais importante para o uso da PBE, seguida da falta de generalização dos achados da literatura científica para sua população de pacientes e falta de fontes de informação.

INTRODUCTION: The interest in applying scientific knowledge to physical therapy practice has grown in recent years. It has been emerged in health care the Evidence Based Practice (EBP), which is a scientific movement that looks for ways to integrate individual experiences of the physical therapy practice with the best available clinical evidence from systematic research. However, little is known about whether physical therapists (PTs) know and apply the EBP in their clinical practice. OBJECTIVE: Therefore, this study aims to verify whether physical therapists are able and skillful on searching scientific literature and if they base their clinical practices on scientific literature. MATERIALS AND METHODS: A descriptive study, with quantitative approach was performed. Sixty-seven PTs, who work in the Greater Florianópolis district, responded a modified online questionnaire from the Evidence-Based Practice (EBP) Questionnaire. RESULTS: The population of the interviewed PTs was mostly young, females with age range between 20 and 29 years old. Possibly because their age, 73.1% of respondents completed their PT degree within the last five years and 71.6% have no post-graduation courses recognized by the Crefito. The PTs alleged to have a positive attitude about EBP and were interested in learning or improving their skills required to implement EBP. They agreed with the need to increase the use of scientific evidence in their daily practice. CONCLUSION: The lack of time was the most important barrier to the use of EBP, which was followed by the difficult in generalizing the findings of the scientific literature for patient populations, and deficient sources of information.

Ajustes posturais antecipatórios e compensatórios ao pegar uma bola em condição de estabilidade e instabilidade postural / Anticipatory and compensatory postural adjustments during catching a ball in condition of postural instability and stability

Indivíduos jovens pré-selecionam suas estratégias de ajuste postural antes que uma perturbação externa ocorra, com base nas características da tarefa. Entretanto, ainda não é bem conhecido de que maneira o sistema nervoso central lida com os ajustes posturais antecipatórios e compensatórios, mediante alguns treinos de equilíbrio que são comumente usados na prática clínica da Fisioterapia. Treze adultos jovens receberam 20 perturbações posturais externas de pegar uma bola arremessada pelo experimentador sobre condições de estabilidade e instabilidade postural (sobre uma espuma). As atividades eletromiográficas dos músculos tríceps braquial (músculo focal), retoabdominal e paravertebral lombar foram avaliadas nas janelas de tempo típicas dos ajustes posturais antecipatórios e compensatórios, assim como o pico do deslocamento do centro de pressão corporal após a perturbação. A magnitude das integrais da atividade eletromiográfica do músculo tríceps braquial foi significativamente menor em condição de instabilidade postural, não houve diferença estatística entre as condições para as integrais da atividade eletromiográfica dos músculos retoabdominal e paravertebral lombar. O pico do deslocamento anteroposterior do centro de pressão corporal foi similar entre as duas condições. Treino de equilíbrio associado à perturbação externa da postura sobre espuma pode não ser mais eficaz ou eficiente do que sobre uma superfície estável, quando se pretende alterar a atividade dos músculos posturais do tronco. Além disso, este tipo de intervenção pode corroborar para diminuir a ativação antecipatória (ajustes posturais antecipatórios) do músculo focal.

Young individuals preselect their postural adjustment strategies before an external perturbation, based on the characteristics of the task. However, it is not well documented how the central nervous system deals with anticipatory and compensatory postural adjustments during some balance training programs, which are commonly used in Physical Therapy settings. Thirteen young individuals were submitted to 20 external postural perturbations of catching a ball thrown by an experimenter in conditions of postural stability and instability (standing on a foam). The electromyographic activities of triceps brachii (focal muscle), rectus abdominis, and lumbar paraspinal muscles were investigated in the time windows typical for anticipatory and compensatory postural adjustments, as well as the center of body pressure peak displacement after the perturbation. The magnitude of the triceps brachii integral electromyographic activity was significantly smaller in conditions of postural instability, there was no statistical difference between the stable and unstable conditions for the integral electromyographic activity of the rectus abdominis, and lumbar paraspinal muscles. The peak of the center of body pressure anterior posterior displacement was similar between the two conditions. Balance training associated with external perturbation standing on a foam might not be more effective or efficient than when standing on a stable surface, when it seeks to modify the activity of the postural trunk muscles. In addition, this balance training may contribute to decrease the electromyographic activity (anticipatory postural adjustments) of the focal muscle.

Quais são as funções dos mecanoreceptores da articulação do ombro?: uma revisão da literatura / What are the functions of the mechanoreceptors in the shoulder joint?: a literature review

Entre as patologias de ombro em pessoas jovens, a instabilidade glenoumeral não traumática é a mais comum, causando dor e sintomas de Síndrome do Impacto. Esse tipo de instabilidade normalmente acomete atletas que praticam atividades as quais exigem repetidas elevações do braço acima da cabeça, tais como voleibol e natação...