EEG changes during passive movements improve the motor imagery feature extraction in BCIs-based sensory feedback calibration.

Objective.This work proposes a method for two calibration schemes based on sensory feedback to extract reliable motor imagery (MI) features, and provide classification outputs more correlated to the user's intention.Method.After filtering the raw electroencephalogram (EEG), a two-step method for spatial feature extraction by using the Riemannian covariance matrices (RCM) method and common spatial patterns is proposed here. It uses EEG data from trials providing feedback, in an intermediate step composed of bothkth nearest neighbors and probability analyses, to find periods of time in which the user probably performed well the MI task without feedback. These periods are then used to extract features with better separability, and train a classifier for MI recognition. For evaluation, an in-house dataset with eight healthy volunteers and two post-stroke patients that performed lower-limb MI, and consequently received passive movements as feedback was used. Other popular public EEG datasets (such as BCI Competition IV dataset IIb, among others) from healthy subjects that executed upper-and lower-limbs MI tasks under continuous visual sensory feedback were further used.Results.The proposed system based on the Riemannian geometry method in two-steps (RCM-RCM) outperformed significantly baseline methods, reaching average accuracy up to 82.29%. These findings show that EEG data on periods providing passive movement can be used to contribute greatly during MI feature extraction.Significance.Unconscious brain responses elicited over the sensorimotor areas may be avoided or greatly reduced by applying our approach in MI-based brain-computer interfaces (BCIs). Therefore, BCI's outputs more correlated to the user's intention can be obtained.

Procesamiento sensorial en menores de seis años con trastorno específico del lenguaje / Sensory processing in children under six years of age with specific language disorder

Introducción: El procesamiento sensorial determina e influencia el nivel de desarrollo que presentan los individuos en la infancia y cuando se afecta alguno de los sistemas que lo integran, se alteran dominios del desarrollo que impiden a los niños desenvolverse de manera adecuada en su entorno. Objetivos: Describir y comparar el procesamiento sensorial de los niños con trastorno específico del lenguaje y con desarrollo típico del lenguaje. Métodos: La muestra estuvo conformada por 60 niños con edades de 4 a 5 años de la escuela especial de lenguaje San Clemente, asignados a dos grupos de acuerdo con la presencia o ausencia de trastorno específico del lenguaje. El procesamiento sensorial se evaluó mediante la escala de procesamiento sensorial. Se evaluó el tipo de distribución de las variables de la escala para su posterior análisis. Resultados: Los niños con trastorno específico del lenguaje obtuvieron 275 puntos y se ubicaron por debajo del puntaje de corte, en cambio los menores con desarrollo típico obtuvieron 309 puntos y se situaron por sobre el puntaje de corte. Es decir, los niños con trastorno específico del lenguaje presentaron un procesamiento sensorial más bajo en comparación con los niños que poseen desarrollo típico del lenguaje con diferencias significativas en el sistema auditivo y propioceptivo. Conclusiones: Los niños con trastorno específico del lenguaje exhiben un desempeño más bajo en tareas de procesamiento sensorial, es por ello, que este último debe ser considerado en la evaluación y diagnóstico de niños con este trastorno para generar un abordaje más integral(AU)

Introduction: Sensory processing determines and influences the level of development presented by individuals in childhood and when any of the systems that integrate it are affected. Developmental domains are altered and they prevent children from developing adequately in their environment. Objectives: To describe and compare sensory processing in children with specific language impairment and typical language development. Methods: The sample consisted of 60 children aged 4 to 5 years from the San Clemente Special Language School, whom were assigned to two groups according to the presence or absence of specific language disorder. Sensory processing was assessed using the sensory processing scale. The type of distribution of the scale variables was evaluated for further analysis. Results: Children with specific language disorder obtained 275 points and were below the cut-off score, while children with typical development obtained 309 points and were above the cut-off score. That is, children with specific language disorder have lower sensory processing compared to children with typical language development with significant differences in the auditory and proprioceptive system. Conclusions: Children with specific language disorder show lower performance in sensory processing tasks, which is why the latter should be considered in the evaluation and diagnosis of children with this disorder to generate a more comprehensive approach(AU)

Influência da privação visual no desempenho do teste de 10rm em homens treinados / Influence of visual privacy on 10rm test performance in trained men / Influencia de la privación visual en el rendimiento de la prueba de 10rm en hombres entrenados

O objetivo do estudo foi avaliar e comparar a carga deslocada no teste de 10 RM sob as condições com e sem a privação visual. A amostra foi composta por 13 homens treinados em força (idade 27,7 ±3 anos). Foram realizadas quatro sessões para teste e reteste de 10 RM nos exercícios: Supino horizontal (SH) e Hack Machine (HM). Para a análise estatística, foi utilizado o test T pareado para comparar os resultados obtidos. Como resultado obtivemos que a carga deslocada com privação visual (PV) no (SH) foi de 150 kg e sem privação (SPV) foi de 135 kg, e para o HM CPV a carga foi de 54 kg e SPV 48 kg. Com base nos resultados apresentados, conclui-se que a carga deslocada CPV foi significativamente maior do que com a visualização das cargas.

the objective of the study was to evaluate and compare the displaced load in the 10 RM test under conditions with and without visual deprivation. The sample consisted of 13 men trained in strength (age 27.7 ± 3 years). Four sessions were used to test and retest 10 RM in the exercises: Horizontal Supine (SH) and Hack Machine (HM). For the statistical analysis, the paired T-test was used to compare the results obtained. As a result we found that the displaced load with visual deprivation (SH) in the SH was 150 kg and without deprivation (SPV) was 135 kg and for the HM CPV the load was 54 kg and the SPV was 48 kg. Based on the results presented, it was concluded that the CPV displaced load was significantly higher than with the visualization of the loads.

El objetivo del estudio fue evaluar y comparar la carga desplazada en la prueba de 10 RM bajo las condiciones con y sin la privación visual. La muestra fue compuesta por 13 hombres entrenados en fuerza (edad 27,7 ± 3 años). Se realizaron cuatro sesiones para prueba y reteste de 10 RM en los ejercicios: Supino horizontal (SH) y Hack Machine (HM). Para el análisis estadístico, se utilizó el test T pareado para comparar los resultados obtenidos. Como resultado obtuvimos que la carga desplazada con privación visual (PV) en el (SH) fue de 150 kg y sin privación (SPV) fue de 135 kg y para el HM CPV la carga fue de 54 kg y SPV 48 kg. Con base en los resultados presentados, se concluye que la carga desplazada CPV fue significativamente mayor que con la visualización de las cargas.

Realidade virtual em pacientes pós-acidente vascular cerebral: revisão sistemática com metanálise de ensaios clínicos randomizados / Virtual reality in patients after stroke: a systematic review and meta-analysis of randomized controlled trials

A prática da realidade virtual na reabilitação de pacientes pós-AVC permite a realização de tarefas orientadas e funcionais, possibilitando fácil adaptação ao grau de função dos pacientes, favorecendo na reabilitação. O objetivo do trabalho foi revisar sistematicamente os efeitos da realidade virtual comparada à fisioterapia convencional ou grupo controle em relação ao equilíbrio, função motora e marcha em pacientes com sequelas crônicas de AVC. A busca incluiu as bases Medline, Pedro, Lilacs e Cochrane Central do início das bases até junho de 2014. Dos 549 ensaios clínicos randomizados identificados, 24 foram incluídos. A intervenção com realidade virtual melhorou: o equilíbrio avaliado com Escala de Equilíbrio de Berg (2,55 pontos; IC 95%: 0,79 a 4,30; I²: 93%); função motora de mão avaliada com Box and Block Test (BBT) (5,89 blocos; IC 95%: 4,32 a 7,46; I²: 0%); função motora de membro superior avaliado com Escala de Fulg-Meyer (3,15 pontos; IC 95%: 2,02 a 4,28; I²: 33%); marcha com teste de caminhada de 10 metros (2,37 cm/s; IC 95%: -8,25 a 13,00; I²: 94%). A realidade virtual mostrou resultados positivos nos pacientes com sequelas de AVC, sendo uma possibilidade relevante dentre os recursos já existentes. (AU)

The practice of virtual reality in the rehabilitation post stroke patients allows oriented and functional tasks, enabling easy adaptation to patients' level of function, favoring rehabilitation. The aim of this study was to review systematically the effects of virtual reality compared to conventional physical therapy or control group regarding on balance, motor function and gait in patients with chronic sequelae of stroke. The search included the Medline, Pedro, Lilacs and Cochrane Central databases from the beginning of bases through June 2014. We identified 549 randomized clinical trials, but included only 24. The intervention improved with virtual reality: the balance assessed with the Berg Balance Scale (2.55 points; 95% CI: 0.79 to 4.30; I²: 93%); hand motor function assessed with Box and Block Test (BBT) (5.89 blocks; 95% CI: 4.32 to 7.46; I²: 0%); of upper limb motor function assessed with Fulg-Meyer Scale (3.15 points; 95% CI: 2.02 to 4.28; I²: 33%); march to walk 10 meters test (2.37 cm / s; 95% CI: -8.25 to 13.00; I²: 94%). The virtual reality showed positive results in patients with stroke sequelae, one possibility among relevant existing resources.(AU)

Efeitos da terapia espelho na recuperação motora e funcional do membro superior com paresia pós-AVC: uma revisão sistemática / Los efectos de la terapia del espejo en la rehabilitación motora y funcional del miembro superior con paresia pos-ACV: revisión sistemática / Effects of mirror therapy on the motor and functional recovery of post-stroke paretic upper limbs: a systematic review

RESUMO Após um acidente vascular cerebral (AVC), o membro superior pode apresentar déficits motores que podem levar a incapacidades funcionais. A terapia espelho (TE) é uma possibilidade terapêutica na reabilitação do membro superior (MS). Este estudo objetivou reunir evidências que pudessem mostrar quais são os efeitos da TE na recuperação motora e funcional do MS com paresia pós-AVC. Foi realizada uma busca eletrônica nas bases de dados SciELO, LILACS, PubMed, PEDro e ScienceDirect, utilizando como critérios de inclusão: ensaios clínicos, nos quais os indivíduos acima de 18 anos apresentassem AVC de qualquer etiologia e em qualquer tempo após a lesão encefálica, com sequela no MS; estudos publicados na íntegra em revistas indexadas nas bases supracitadas entre 2010 e 2015, nos idiomas inglês e português, que utilizassem a TE para reabilitação do MS de pacientes com AVC, apresentando como desfechos função motora e independência funcional. Os artigos resultantes foram avaliados pela escala PEDro quanto à qualidade metodológica. Treze ensaios clínicos avaliaram efeitos da TE no MS parético. Os testes mais utilizados foram escala de Fugl-Meyer e Medida de Independência Funcional. Nesses estudos, a TE foi eficaz na recuperação motora do MS e na independência funcional dos pacientes, especialmente nos quesitos transferências e autocuidados. Os artigos foram considerados de moderada a alta qualidade metodológica. Conclui-se que a TE promoveu melhora significativa da função motora e da independência funcional do MS parético pós-AVC independente do tempo decorrido após a lesão encefálica.

RESUMEN Debido al accidente cerebrovascular (ACV), los miembros superiores pueden presentar problemas motores, que pueden llevar a incapacidades funcionales. La terapia del espejo (TE) presenta una posibilidad terapéutica de rehabilitar los miembros superiores (MS). El propósito de este estudio es reunir evidencias que muestran cuáles son los efectos de la TE en la rehabilitación motora y funcional de MS con paresia pos-ACV. Se buscó en las bases de datos SciELO, LILACS, PubMed, PEDro y ScienceDirect, empleando los siguientes criterios de inclusión: estudios clínicos, en los cuales los sujetos de más de 18 años presentaron ACV de cualquier etiología y de cualquier tiempo tras la lesión cerebral, con secuela en MS; textos publicados integralmente entre 2010 y 2015 en revistas científicas de las citadas bases de datos, en lengua inglesa y en portugués brasileño, que empleasen la TE en la rehabilitación de MS de pacientes con ACV y presentasen como resultados función motora e independencia funcional. Los textos recolectados fueron evaluados por la escala PEDro en función de la calidad metodológica. Trece estudios clínicos evaluaron los efectos de la TE en MS parético. Las pruebas más empleadas fueron la escala Fugl-Meyer y la Medida de Independencia Funcional. En estos estudios se comprobó la eficacia de la TE en la rehabilitación motora de MS y en la independencia funcional de los pacientes, especialmente en los aspectos transferencia y autocuidado. Se evaluaron los textos como de moderada a alta calidad metodológica. Se concluye que la TE mejora significativamente la función motora y la independencia funcional de MS parético pos-ACV independiente del tiempo transcurrido de la lesión cerebral.

ABSTRACT After a stroke upper limbs may display motor deficits that could lead to functional disability. Mirror therapy (MT) is a therapeutic tool in the rehabilitation of upper limbs (UL). This study aimed to bring together evidence to show the main effects of MT in the motor recovery of paretic upper limbs after a stroke. An electronic search on the Lilacs, Scielo, PubMed, PEDro and ScienceDirect databases was performed, in accordance with the inclusion criteria: clinical trials, in which individuals should have had a stroke of any etiology and in any stage of recovery, with UL impairment, published in full in journals indexed in those databases, between 2010 and 2015, in English or Portuguese, using MT for the rehabilitation of these patients’ UL, with motor function and functional independence as main outcomes. The remaining articles were evaluated with the PEDro scale to assign their methodological quality a score. Thirteen clinical studies evaluated the effects of MT in the motor function and functional independence of the upper limbs after a stroke. Fugl-Meyer scale and the Functional Independence Measure were frequently used in the studies, which showed that MT is efficient in upper limb motor recovery and functional independence, especially concerning transferring and self-care. Regarding the methodological evaluation, the articles were considered as having moderate or high quality. In conclusion, MT promotes significant improvement of the motor function and functional independence of paretic upper limbs after a stroke, regardless of the time elapsed after the encephalic lesion.

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

Impacto do treinamento sensório-motor com plataforma vibratória no equilíbrio e na mobilidade funcional de um indivíduo idoso com sequela de acidente vascular encefálico: relato de caso / Efecto del entrenamiento sensorial-motor con plataforma vibratoria en el balance y en la movilidad funcional de una persona mayor con secuela de accidente cerebrovascular: un relato de caso / Impact of sensorimotor training with whole body vibration platform on balance and functional mobility of an elderly individual after a stroke: case report

RESUMO A incidência de acidente vascular encefálico (AVE) aumenta com o envelhecimento e pode ter como consequência alterações sensitivas e motoras, as quais limitam a capacidade funcional, em função da redução do equilíbrio e da mobilidade. Diferentes recursos vêm sendo utilizados na prática fisioterapêutica para a recuperação do equilíbrio e da mobilidade, como treinamento sensório-motor e treinamento com plataforma vibratória. O objetivo deste estudo foi investigar o efeito de um protocolo de treinamento sensório-motor com plataforma vibratória no equilíbrio e na mobilidade funcional de um indivíduo idoso com sequela de AVE. Um indivíduo idoso, do gênero feminino, com 72 anos de idade e com sequela de AVE participou deste estudo. A avaliação do equilíbrio foi realizada por meio da Escala de Equilíbrio de Berg (EEB) e a avaliação da mobilidade por meio do teste Timed Up and Go (TUG). As variáveis dependentes para acompanhamento foram: pontuação obtida na EEB e tempo de execução do TUG. Após a avaliação inicial, a idosa realizou um protocolo de treinamento sensório-motor com plataforma vibratória, composto por 10 sessões, de 45 minutos cada. Na avaliação final, os resultados indicaram um aumento da pontuação na EEB (avaliação inicial = 41 pontos e avaliação final = 51 pontos) e uma redução no tempo de execução do TUG (avaliação inicial = 14 segundos e avaliação final = 9 segundos) na idosa com sequela de AVE. Com base nesses resultados, é possível concluir que o treinamento proposto foi efetivo para a melhora do equilíbrio e da mobilidade funcional da idosa com sequela de AVE.

RESUMEN La incidencia del accidente cerebrovascular (ACV) aumenta con el envejecimiento, y su consecuencia puede ser las alteraciones sensoriales y motoras, que restringen la capacidad funcional, debido a la reducción del balance y de la movilidad. En la práctica fisioterapéutica para recuperarles a los sujetos el balance y la movilidad, se están utilizando diversos recursos, tales como el entrenamiento sensorial-motor y el entrenamiento con plataforma vibratoria. Este estudio se propone a investigar el efecto de un protocolo de entrenamiento sensorial-motor con plataforma vibratoria en el balance y en la movilidad funcional de una persona mayor con secuela del ACV. Participó del estudio una persona mayor, mujer, con 72 años de edad y con secuela del ACV. Se realizó la evaluación del balance mediante la Escala de Equilibrio de Berg (EEB) y la evaluación de la movilidad a través del test Timed Up and Go (TUG). Las variables dependientes para análisis fueron: la puntuación obtenida en la EEB y el tiempo de ejecución del TUG. Tras la evaluación inicial, la participante realizó un protocolo de entrenamiento sensorial-motor con plataforma vibratoria, compuesto de 10 sesiones, de 45 minutos cada una. En la evaluación final, los resultados de la participante señalaron un aumento de la puntuación en la EEB (evaluación inicial = 41 puntos y evaluación final = 51 puntos) y una reducción en el tiempo de ejecución del TUG (evaluación inicial = 14 segundos y evaluación final = 9 segundos). Según estos resultados, se concluye que el entrenamiento propuesto produjo efecto en la mejora del balance y de la movilidad funcional de la participante con secuela del ACV.

ABSTRACT The incidence of cerebrovascular accident (CVA) increases with aging and can result in sensory and motor changes, which limit functional capacity due to the reduction in balance and mobility. Different resources are being used by physical therapists in their practice to recover balance and mobility, such as sensorimotor training and training with a vibrating platform. The objective of this study was to investigate the effect of a sensorimotor training protocol with vibrating platform on the balance and functional mobility of an older adult with CVA sequela. An older adult, of the female sex, aged 72 years and with CVA sequela participated in this study. The assessment of balance was performed through the Berg Balance Scale (BBS) and the assessment of mobility through the Timed Up and Go Test (TUG). The dependent variables for monitoring were: score obtained through BBS and execution time of TUG. After the initial assessment, the older adult went through a sensorimotor training protocol with a vibration platform, comprised of 10 sessions of 45 minutes. With the final assessment, the results showed an increase in the scores of BBS (initial assessment = 41 points; final assessment = 51 points) and a reduction in the execution time of TUG (initial assessment = 14 seconds; final assessment = 9 seconds) in the older adult with CVA sequela. Based on these results, we can conclude that the proposed training was effective for the improvement of balance and functional mobility of the older adult with CVA sequela.

Effects of vibrotactile vestibular substitution on vestibular rehabilitation - preliminary study, / Efeitos do biofeedback vibrotátil na reabilitação do equilíbrio corporal − estudo preliminar

ABSTRACT INTRODUCTION: Some patients with severe impairment of body balance do not obtain adequate improvement from vestibular rehabilitation (VR). OBJECTIVE: To evaluate the effectiveness of Vertiguard(tm) biofeedback equipment as a sensory substitution (SS) of the vestibular system in patients who did not obtain sufficient improvement from VR. METHODS: This was a randomized prospective clinical study. Thirteen patients without satisfactory response to conventional VR were randomized into a study group (SG), which received the vibrotactile stimulus from Vertiguard(tm) for ten days, and a control group (CG), which used equipment without the stimulus. For pre- and post-treatment assessment, the Sensory Organization Test (SOT) protocol of the Computerized Dynamic Posturography (CDP) and two scales of balance self-perception, Activities-specific Balance Confidence (ABC) and Dizziness Handicap Inventory (DHI), were used. RESULTS: After treatment, only the SG showed statistically significant improvement in C5 (p = 0.007) and C6 (p = 0.01). On the ABC scale, there was a significant difference in the SG (p= 0.04). The DHI showed a significant difference in CG and SG with regard to the physical aspect, and only in the SG for the functional aspect (p = 0.04). CONCLUSION: The present findings show that sensory substitution using the vibrotactile stimulus of the Vertiguard(tm) system helped with the integration of neural networks involved in maintaining posture, improving the strategies used in the recovery of body balance.

RESUMO INTRODUÇÃO: Alguns pacientes com déficit severo do equilíbrio corporal submetidos à reabilitação vestibular (RV) podem não apresentar resultados satisfatórios. OBJETIVO: Verificar a eficácia do equipamento de biofeedback Vertiguard(tm) como substituto sensorial do sistema vestibular em pacientes sem bons resultados à RV. MÉTODO: Estudo prospectivo clínico randomizado. Treze pacientes sem resposta satisfatória à RV convencional foram randomizados entre grupo de estudo (GE), que utilizou o estímulo vibratório do Vertiguard(tm) por dez dias e grupo controle (GC) que usou o equipamento desligado. Para avaliação pré e pós-tratamento foi utilizado o protocolo Teste de Integração Sensorial (TIS) da Posturografia Dinâmica Computadorizada (PDC) e duas escalas de autopercepção do equilíbrio: ABC (Activities-specific Balance Confidence) e DHI (Dizziness Handicap Inventory). RESULTADOS: Apenas o GE apresentou melhora estatisticamente significante em C5 (p = 0,007) e C6 (p = 0,01) da PDC após treinamento. Na escala ABC houve diferença significante no GE (p = 0,04). No DHI ocorreu diferença significante no aspecto físico em ambos os grupos e no aspecto funcional (p= 0,04) apenas no GE. CONCLUSÃO: O estímulo de substituição sensorial do Vertiguard(tm) auxiliou a integração das redes neurais e na manutenção da postura, melhorando as estratégias utilizadas na recuperação do equilíbrio corporal.

Effects of vibrotactile vestibular substitution on vestibular rehabilitation - preliminary study.

INTRODUCTION: Some patients with severe impairment of body balance do not obtain adequate improvement from vestibular rehabilitation (VR). OBJECTIVE: To evaluate the effectiveness of Vertiguard™ biofeedback equipment as a sensory substitution (SS) of the vestibular system in patients who did not obtain sufficient improvement from VR. METHODS: This was a randomized prospective clinical study. Thirteen patients without satisfactory response to conventional VR were randomized into a study group (SG), which received the vibrotactile stimulus from Vertiguard™ for ten days, and a control group (CG), which used equipment without the stimulus. For pre- and post-treatment assessment, the Sensory Organization Test (SOT) protocol of the Computerized Dynamic Posturography (CDP) and two scales of balance self-perception, Activities-specific Balance Confidence (ABC) and Dizziness Handicap Inventory (DHI), were used. RESULTS: After treatment, only the SG showed statistically significant improvement in C5 (p=0.007) and C6 (p=0.01). On the ABC scale, there was a significant difference in the SG (p=0.04). The DHI showed a significant difference in CG and SG with regard to the physical aspect, and only in the SG for the functional aspect (p=0.04). CONCLUSION: The present findings show that sensory substitution using the vibrotactile stimulus of the Vertiguard™ system helped with the integration of neural networks involved in maintaining posture, improving the strategies used in the recovery of body balance.

Effect of light touch on postural sway in individuals with balance problems: a systematic review.

The aim of the present review was to examine the experimental, case-control studies that investigated the effect of light touch on postural sway in individuals with balance problems due to aging, brain lesion or other motor or sensory deficits. Articles published before the end of March of 2013 were searched in PubMed, Scielo and Lilacs databases using terms related to postural control and sensory information. Twelve studies that assessed the postural sway of individuals with balance problems during quiet standing with the light touch using a force plate were reviewed. Two reviewers rated all selected articles as having good quality. The effect of light touch on postural control was reported by all eligible studies regardless of the cause of the balance problem of the participants. Such effect was more evident when the applied vertical force was greater than 1N, but if individuals with poor balance took more advantage of the light touch than healthy ones it depended on the source of their balance problems and not the amount of the applied force. These findings suggested that the maintenance of the fingertip lightly touching an external surface could provide additional somatosensory information for individuals with poor balance and then it could be used as a strategy to improve the control of upright standing during intervention programs.

Static postural balance in healthy individuals: comparisons between three age groups / Equilíbrio postural estático em indivíduos saudáveis: comparações entre três grupos etários / Equilibrio postural estático en individuos sanos: las comparaciones entre los tres grupos de edad

The aim of the study was to compare static postural balance of healthy individuals of three age groups in different conditions of support and vision. Seventy one individuals, divided into 3 groups, were analyzed: young group (YG: 22.2 ± 2.1 years), middle aged group (MAG: 50.7 ± 5.7 years) and older individuals group (EG: 66.8 ± 5.4 years). Their balance was tested on a force platform, under 3 support and 3 visual conditions. Measures included: total (TD), anterior-posterior (APD) and mediolateral displacement (MLD) of the center of pressure (CoP). ANOVA revealed significant differences for interactions between group X support conditions and group X visual conditions for the 3 variables (p<0.01), with greater displacements for the MAG and EG groups during single-leg stance with partial and occluded vision (p<0.05). Static postural balance decreased over time in healthy individuals, and conditions of support and visual negatively affected balance with the increment of age.

O objetivo do estudo foi comparar o equilíbrio postural estático de indivíduos saudáveis de três faixas etárias em diferentes condições de apoio e de visão. Foram analisados 71 sujeitos, divididos em 3 grupos: jovens (GJ: 22,2±2,1 anos); meia idade (GMI: 50,7±5,7 anos) e idosos (GI: 66,8±5,4 anos). O equilíbrio foi testado numa plataforma de força, em 3 condições de apoio e 3 condições de visão, avaliando-se o deslocamento total (DT), ântero-posterior (DAP) e médio-lateral (DML) do centro de pressão (CP). ANOVA mostrou interação grupo X condições de apoio e grupo X condições visuais, nas 3 variáveis estudadas (p<0,01), com maiores deslocamentos no GMI e GI no apoio unipodal com visão parcial e ausente (p<0,05). O equilíbrio postural estático em indivíduos saudáveis diminuiu ao longo do tempo e que as condições de apoio e de visão podem afetá-lo negativamente com o avançar da idade.

El objetivo del estudio fue comparar el equilibrio postural estático de individuos sanos de tres grupos de edad em diferentes condiciones de apoyo y visón. Fueran analizados 71 sujetos, divididos en 3 grupos: jóvenes (GJ: 22,2±2,1 años), de mediana edad (GME: 50,7±5,7 años) y ancianos (GA: 66,8±5,4 años). El equilibrio fue probado en una plataforma de fuerza, em 3 condiciones de apoyo y 3 condiciones de visión, evaluando el desplazamiento total (DT), anteroposterior (DAP) y mediolateral (DML) del centro de presión (CP). ANOVA mostró interacción grupo X condiciones de apoyo y grupo X condiciones visuales, en las 3 variables (p<0,01), con grandes desplazamientos en GME y GA en apoyo unipodal con visión parcial y ausente (p<0,05). El equilibrio postural estático disminuyó en individuos sanos con el tiempo y que las condiciones de apoyo y de visión pueden afectarle negativamente con la edad.

Uso da informação somatossensorial adicional no controle postural: efeito da dominância manual / The use of additional somatosensory information on postural control: effect of handedness

Buscamos com o presente estudo investigar o efeito da dominância manual e da visão no uso da informação somatossensorial adicional fornecida pelo toque suave no controle postural. Quinze adultos jovens e destros permaneceram em pé sobre uma plataforma de força com a) olhos abertos ou fechados e b) braços ao lado do corpo ou o dedo indicador direito ou esquerdo tocando a barra fixa. A área do centro de pressão (CP), amplitude e velocidade médias do CP nas direções anteroposterior e médio-lateral foram avaliadas. Os resultados indicaram uma redução nas medidas nas condições de toque e aumento com os olhos fechados, exceto quando o toque foi realizado com dedo indicador direito. A força máxima foi maior para a mão direita, enquanto a sensibilidade cutânea e as forças aplicadas à barra foram similares entre os hemicorpos. Esses resultados sugerem um efeito da dominância manual e visão no uso da informação somatossensorial adicional no controle postural...

In this study we investigated the effect of handedness and vision on the use of additional somatosensory information provided by the light touch in postural control. Fifteen right-handed, young adults quietly stood on a force plate with a) eyes open or closed and b) arms hanging along the body or with the right or left index finger in contact with a rigid bar. We assessed the center of pressure (CP) area and CP mean sway amplitude and velocity in anterior-posterior and medial-lateral directions. The results revealed a reduction of these measures in the touch conditions and increase with the eyes closed, except when the touch was performed with right index fingertip. The grip strength was greater for the right hand, while the cutaneous sensitivity and the forces applied on the bar were similar between the two sides of the body. These results suggested an effect of the handedness and vision in the use of additional somatosensory information on the postural control...

Treinamento sensório-motor com Nintendo Wii e disco proprioceptivo: efeitos sobre o equilíbrio de mulheres jovens saudáveis / Sensory-motor training with Nintendo Wii and proprioceptive disk: effects on the balance of healthy young women

Muitos sistemas estão envolvidos na manutenção do equilíbrio humano, como os sistemas visual, vestibular e somatossensorial. O estímulo a esses sistemas pode contribuir na promoção ou recuperação do controle postural. Com isso, o presente estudo objetivou verificar os efeitos do treinamento sensório-motor, utilizando como ferramentas o console interativo Nintendo Wii® e o disco proprioceptivo, no equilíbrio de mulheres jovens saudáveis. Participaram desta pesquisa 14 mulheres saudáveis (média de idade de 20,7 ± 2,6 anos) divididas em dois grupos: um realizou o treinamento utilizando o console Nintendo Wii® e o outro realizou o treinamento utilizando o disco proprioceptivo. Foram realizadas 10 sessões de treinamento, três vezes por semana, com duração de 15 minutos cada sessão de treinamento. Foi avaliado o equilíbrio estático através do Balance Error Scoring System e o equilíbrio dinâmico através do Star Excursion Balance Test (SEBT). A partir dos resultados obtidos pré e pós treinamento, ambos os grupos apresentaram melhora no equilíbrio dinâmico após o treinamento, verificado através do aumento nas distâncias alcançadas nas direções póstero-medial e lateral do SEBT (p<0,05). Não foram observadas diferenças entre os grupos quando comparado os resultados finais dos dois grupos (p>0,05). Desta forma, pode-se concluir que o treinamento sensório-motor utilizando o console Nintendo Wii® como ferramenta, pode ser usada para a melhora do controle postural, mostrando resultados semelhantes ao treinamento com disco proprioceptivo.

Many systems are involved in maintaining balance human, like the visual, vestibular and somatosensory system. The stimulation these systems may contribute to the promotion or recovery of postural control. Thus, this study aimed to verify the effects of sensory-motor training using like tools the interactive console Nintendo Wii™ and the disk proprioceptive balance in healthy young women. Participated in this study 14 healthy women (mean age 20.7 ± 2.6 years) were divided into two groups: one conducted the training using the Nintendo Wii™ and the other conducted the training using the disk proprioceptive. We were conducted 10 training sessions, three times a week, with duration of 15 minutes each training session. Static balance was assessed using the Balance Error Scoring System and the dynamic balance was assessed using the Star Excursion Balance Test (SEBT). From the results obtained before and after training, both groups showed an increase in dynamic balance after training, verified by increasing the distances reached in the directions posteromedial and lateral of the SEBT (p<0.05). No differences were observed between groups when comparing the final results of the two groups (p>0.05). Therefore, we conclude that the sensory-motor training using the Nintendo Wii™ as a tool can be used for the stimulation of postural control, showing similar results to training using the disk proprioceptive.

Muscle repositioning: combining subjective and objective feedbacks in the teaching and practice of a reflex-based myofascial release technique.

Muscle Repositioning (MR) is a new style of myofascial release that elicits involuntary motor reactions detectable by electromyography. This article describes the principal theoretical and practical concepts of MR, and summarizes a workshop presented October 31, 2009, after the Second International Fascia Research Congress, held at Vrije Universitiet, Amsterdam.The manual mechanical input of MR integrates the client's body segments into a block, which is evident as a result of the diagnostic manual oscillations the practitioner imparts to the client's body. Segmental integration is achieved when the client's body responds as a unit to the oscillatory assessment. It appears that manually sustaining the condition of segmental integration evokes involuntary muscle reactions, which reactions might correspond to mechanisms that maintain homeostasis, such as pandiculation. It might be that these reactions are part of the MR mechanism of action and underlie its clinically observed efficacy in the treatment of musculoskeletal disorders.For the practitioner and the client alike, segmental integration provides unique sensations. In teaching MR, these paired sensations can be used as kinesthetic feedback resources, because quality of touch can be guided by the client's reported sensations, which should match the practitioner's sensations. Another form of feedback with respect to quality of touch is the visually discernable degree of segmental integration. Finally, because the involuntary motor activity elicited by the MR touch can be objectively monitored through electromyography and possibly other instrumented measurements, the MR approach might yield objectivity, precision, and reproducibility-features seldom found in manual therapies.