Effects of stance control via hidden Markov model-based gait phase detection on healthy users of an active hip-knee exoskeleton.

Introduction: In the past years, robotic lower-limb exoskeletons have become a powerful tool to help clinicians improve the rehabilitation process of patients who have suffered from neurological disorders, such as stroke, by applying intensive and repetitive training. However, active subject participation is considered to be an important feature to promote neuroplasticity during gait training. To this end, the present study presents the performance assessment of the AGoRA exoskeleton, a stance-controlled wearable device designed to assist overground walking by unilaterally actuating the knee and hip joints. Methods: The exoskeleton's control approach relies on an admittance controller, that varies the system impedance according to the gait phase detected through an adaptive method based on a hidden Markov model. This strategy seeks to comply with the assistance-as-needed rationale, i.e., an assistive device should only intervene when the patient is in need by applying Human-Robot interaction (HRI). As a proof of concept of such a control strategy, a pilot study comparing three experimental conditions (i.e., unassisted, transparent mode, and stance control mode) was carried out to evaluate the exoskeleton's short-term effects on the overground gait pattern of healthy subjects. Gait spatiotemporal parameters and lower-limb kinematics were captured using a 3D-motion analysis system Vicon during the walking trials. Results and Discussion: By having found only significant differences between the actuated conditions and the unassisted condition in terms of gait velocity (ρ = 0.048) and knee flexion (ρ ≤ 0.001), the performance of the AGoRA exoskeleton seems to be comparable to those identified in previous studies found in the literature. This outcome also suggests that future efforts should focus on the improvement of the fastening system in pursuit of kinematic compatibility and enhanced compliance.

"Vaccines for pregnant women ?! Absurd" - Mapping maternal vaccination discourse and stance on social media over six months.

OBJECTIVE: To understand the predominant topics of discussion, stance and associated language used on social media platforms relating to maternal vaccines in 15 countries over a six-month period. BACKGROUND: In 2019, the World Health Organisation prioritised vaccine hesitancy as a top ten global health threat and recognized the role of viral misinformation on social media as propagating vaccine hesitancy. Maternal vaccination offers the potential to improve maternal and child health, and to reduce the risk of severe morbidity and mortality in pregnancy. Understanding the topics of discussion, stance and language used around maternal vaccines on social media can inform public health bodies on how to combat vaccine misinformation and vaccine hesitancy. METHODS: Social media data was extracted (Twitter, forums, blogs and comments) for six months from 15 countries (Australia, Brazil, Canada, France, Germany, India, Italy, Korea, Mexico, Panama, South Africa, Spain, United Kingdom and United States). We used stance, discourse and topic analysis to provide insight into the most frequent and weighted keywords, hashtags and themes of conversation within and across countries. RESULTS: We exported a total of 19,192 social media posts in 16 languages obtained between 1st November 2018 and 30th April 2019. After screening all posts, 16,000 were included in analyses, while excluding retweets, 2,722 were annotated for sentiment. Main topics of discussion were the safety of the maternal influenza and pertussis vaccines. Discouraging posts were most common in Italy (44.9%), and the USA (30.8%). CONCLUSION: The content and stance of maternal vaccination posts from November 2018 to April 2019 differed across countries, however specific topics of discussion were not limited to geographical location. These discussions included the promotion of vaccination, involvement of pregnant women in vaccine research, and the trust and transparency of institutions. Future research should examine the relationship between stance (promotional, neutral, ambiguous, discouraging) online and maternal vaccination uptake in the respective regions.

Diagnostic Accuracy of Clinical Tests for the Indirect Assessment of Hip Abductor Muscle Strength in Community-Dwelling Older Women.

OBJECTIVE: The objective of this study was to determine the accuracy of 3 clinical tests (lateral step [LS], tandem gait [TG], and single-leg stance [SS]) in identifying older women with reduced hip abductor muscle strength and to determine the post-test probability of each test and of their combination in changing the certainty of diagnosis. METHODS: In this cross-sectional study, a total of 123 older women received clinical testing to obtain the variables LS height, time for TG execution, percentage of errors in TG, and time of permanence on SS and were tested for isometric hip abductor peak torque using an isokinetic dynamometer. Only the dominant lower limb was evaluated. Multiple linear regression analysis with adjustment was performed to determine the association among variables, followed by the receiver operating characteristic curve to identify clinical variables that can discriminate older women with reduced abductor muscle strength. Post-test probability was then calculated based on the receiver operating characteristic curve data. RESULTS: Although the 4 clinical variables showed correlation with abductor peak torque, only LS and TG time were able to discriminate reduced abductor muscle strength with low accuracy (area under the curve was between 0.5 and 0.7). However, the combination of LS and TG time increased post-test probability from 47% (prevalence of weakness in the population) to 76% when both tests were positive and reduced it from 47% to 18% when both tests were negative. CONCLUSION: The combination of the LS test and TG time is useful for the indirect assessment of hip abductor strength in community-dwelling older women. IMPACT: Hip abductor muscle strength is extremely important for function in older women. This study presents clinicians with simple, fast, and inexpensive methods for assessing hip abductor muscle strength.

How Do Object Shape, Semantic Cues, and Apparent Velocity Affect the Attribution of Intentionality to Figures With Different Types of Movements?

A series of experiments show that attribution of intentionality to figures depends on the interaction between the type of movement -Theory of Mind (ToM), Goal-Directed (GD), Random (R)- with the presence of human attributes, the way these figures are labeled, and their apparent velocity. In addition, the effect of these conditions or their interaction varies when the use of human nouns -present in the participant's responses- is statistically controlled. In Experiment 1, one group of participants observed triangular figures (n = 46) and another observed humanized figures, called Stickman figures (n = 38). In ToM movements, participants attributed more intentionality to triangular figures than to Stickman figures. However, in R movements, the opposite trend was observed. In Experiment 2 (n = 42), triangular figures were presented as if they were people and compared to triangular figures presented in Experiment 1. Here, when the figures were labeled as people the attribution of intentionality only increased in R and GD movements, but not in ToM movements. Finally, in Experiment 3, Stickman figures (n = 45) move at a higher (unnatural) speed with higher frames per second (fps) than the Stickman figures of Experiment 1. This manipulation decreased the attribution of intentionality in R and GD movements but not in ToM movements. In general terms, it was found that the human attributes and labels promote the use of human nouns in participants' responses, while a high apparent speed reduces their use. The use of human nouns was associated to intentionality scores significantly in R movements, but at a lesser extent in GD and ToM movements. We conclude that, although the type of movement is the most important cue in this sort of task, the tendency to attribute intentionality to figures is affected by the interaction between perceptual and semantic cues (figure shape, label, and apparent speed).

Educational goals for college students diagnosed with disabilities: from individualist to transformative activist agenda / Metas educacionais para universitários diagnosticados com deficiência: de uma proposta individualista à ativista transformadora / Metas educacionales para estudiantes universitarios diagnosticados con discapacidad: de una propuesta individualista a una activista transformadora

Due to the legal protections and the effects of inclusive reforms introduced in the U.S. in the last decades, the number of students diagnosed with disabilities (SDWD) entering post-secondary education in the country has steadily increased. Nevertheless, SDWD remain significantly underrepresented among the college student population and their graduation rates are lower than those of their able-bodies peers'. Common explanations of unequal outcomes of SDWD in college have invoked issues related to students' transitioning from high school to college and inadequate provision of diversified and adequate support. In this paper, I critically examine the scholarship on academic success of SDWD in higher education that shape institutional discourses and practices around educational and life goals for SDWD. My analysis reveals that narrowly individualistic notions of personal responsibility, autonomy, self-determination and self-advocacy skills dominate such practices and discourses. My contention is that a focus on achieving independence as the ultimate educational goal for SDWD reproduces ableistic assumptions and ultimately disempowers those students. Merging insights from critical disability studies with the Vygotskian socio-historical theory expanded by the Transformative Activist Stance, I propose a radical reconceptualization of developmental goals for SDWD away from the notion of independence of individual learners toward focusing on interdependence, reciprocity, relationality, connectedness and collective agency.

Devido às proteções legais e aos efeitos das reformas inclusivas introduzidas nos EUA nas últimas décadas, o número de alunos diagnosticados com deficiência (SDWD) ingressando no ensino superior no país tem aumentado constantemente. Entretanto, o aluno diagnosticado com deficiência permanece significativamente sub-representado e apresenta taxas de graduação menores entre a população de estudantes universitários. Explicações comuns de desfechos desiguais de alunos com deficiência na faculdade têm invocado questões relacionadas à transição dos alunos do ensino médio para a faculdade e a oferta inadequada de apoio adequado e diversificado. Neste artigo, examina-se criticamente a bolsa de estudos e o sucesso acadêmico dos alunos com deficiência no ensino superior, que molda discursos institucionais e práticas em torno das metas educacionais e de vida para os alunos com deficiência. A análise revela que noções estritamente individualistas de responsabilidade pessoal, autonomia, autodeterminação e habilidades de autodefesa dominam tais práticas e discursos. Discute-se que o foco em alcançar a independência como o objetivo educacional final para o aluno com deficiência reproduz discriminações; em última instância, descapacita esses alunos. Unindo a abordagem de estudos críticos de incapacidade com a teoria sócio histórica vygotskiana expandida pelo Posicionamento Ativista Transformador, propõe-se uma reconceitualização radical dos objetivos de desenvolvimento para o aluno com deficiência, longe da noção de independência dos alunos individuais para focar na interdependência, reciprocidade, conectividade e na importância das relações e ações coletivas.

Debido a las protecciones legales y a los efectos de la reformas inclusivas introducidas en los EE.UU en las últimas décadas, el número de estudiantes diagnosticados con discapacidades que ingresan en la educación superior en el país ha aumentado constantemente. Sin embargo, el número de estudiantes diagnosticados con discapacidad sigue siendo muy pequeño entre la población de estudiantes universitarios y, sus notas de graduación son mas bajas que que las de sus compañeros sin discapacidad. Las explicaciones comunes de esta disparidad entre los estudiantes con discapacidades e sus compañeros sin discapacidad en la universidad han planteado problemas relacionados con la transición de la secundaria a la universidad y la provisión inadecuada de suporte diverso y adecuado. Este artículo examina críticamente los estudios sobre el éxito académico de las personas con discapacidades en la educación superior que respaldan los discursos y prácticas institucionales en torno a las metas educacionales y de vida de los estudiantes diagnosticados con discapacidad. El análisis revela que estas comunicaciones y prácticas son el resultado de una "estrecha" noción individualista de responsabilidad personal, autonomía, autodeterminación y habilidades de autodefensa que dominan tales discursos y prácticas. Se argumenta que el enfoque en el logro de la independencia como objetivo educativo último para los estudiantes con discapacidad reproduce la discriminación; en última instancia, fragiliza a estos estudiantes. Uniendo el enfoque de los estudios críticos de la discapacidad con la teoría socio histórica vygotskiana ampliada por la Postura Activista Transformadora, proponemos una reelaboración radical de los objetivos de desarrollo para los estudiantes diagnosticados con discapacidad, lejos de la noción de independencia de el alumno individualmente, para enfocarse en la interdependencia, reciprocidad, conectividad y la importancia de las relaciones y acciones colectivas.

High contextual interference in perturbation-based balance training leads to persistent and generalizable stability gains of compensatory limb movements.

Reactive responses to balance perturbations have been shown to be improved by training. This investigation aimed to compare the effects of block and random training perturbation schedules on stability gains of compensatory arm and leg movements in response to unpredictable large-magnitude balance perturbations. Perturbations were produced by means of sudden displacements of the support base, associating mode (rotation, translation, combined), direction, and velocity of platform motion. Healthy young participants were assigned to one of three groups: random, block, and control. For the random group, perturbation sequence was unpredictable. For the block group, each balance perturbation was repeated over blocks of four trials. Controls were tested only, serving as reference of first trial responses in the post-test. Evaluation was made through a scale rating stability of compensatory arm and leg movements (CALM). We probed immediate and persistence gains (1-week retention), in addition to generalizability to perturbations of higher velocity and to dual-tasking (mental subtraction). In the post-test both the block and random groups achieved higher leg and global scores in comparison with controls in the most challenging perturbations. In retention and transfer tests, results for the global score indicated higher values for the random than for the block and control groups. These results support the conclusion that high but not low contextual interference in perturbation-based balance training leads to enduring and generalizable increased stability gains of compensatory limb movements in response to unpredictable balance perturbations.

Reliability and robustness of optimization properties for stabilization of the upright stance as determined using posturography.

Diagnostic value of static posturography depends on its methodological features, measurement properties, and on computational methods that extract meaningful information from the postural sway i.e. the center-of-pressure (CoP) displacements. In this study, we assessed the reliability and robustness of the postural system based on the optimization properties of the CoP signal: descending, local and global stability, and convergence. For the analysis, we used CoP data from 146 participants (104 [71%] female, age 46 ± 23 years, body mass index 23.6 ± 3.4 kg/m2) recorded while standing quietly on a foam surface without visual input. Reliability was estimated using the intraclass correlation coefficient from a single (ICC2,1) and averaged (ICC2,3) measurements. Robustness was assessed through main and interaction effects for the signal duration (60, 30 s), sampling frequency (100, 50 Hz), and lowpass filtering cutoff frequency (10, 5 Hz). The observed reliability depended on the use of average or single measurements as it was excellent for the stability property (ICC2,k ≥ 0.772); excellent-to-acceptable (ICC2,3 ≥ 0.540) or excellent-to-unacceptable (ICC2,1 ≥ 0.281) for the descending property; and excellent-to-unacceptable (ICC2,3 > 0.295; ICC2,1 > 0.122) for the convergence property. Robustness analysis showed large main effects of signal duration (ω2 ≤ 0.834, p < 0.001), sampling frequency (ω2 ≤ 0.526, p < 0.001), and the lowpass filter cutoff frequency (ω2 ≤ 0.523, p < 0.001) on the optimization properties; but all two-way and three-way effects varied from medium to trivial. Reliability is thus excellent to acceptable for deriving the descending, stability, and convergence properties from the average of three measurements. Those optimization properties are robust to the interaction but not the main effects of methodological sources of variation of posturography.

Automatic postural responses are scaled from the association between online feedback and feedforward control.

Generation of automatic postural responses (APRs) scaled to magnitude of unanticipated postural perturbations is required to recover upright body stability. In the current experiment, we aimed to evaluate the effect of previous postural perturbations on APR scaling under conditions in which the current perturbation is equal to or different from the previous perturbation load inducing unanticipated forward body sway. We hypothesized that the APR is scaled from the association of the current perturbation magnitude and postural responses to preceding perturbations. Evaluation was made by comparing postural responses in the contexts of progressive increasing versus decreasing magnitudes of perturbation loads. Perturbation was applied by unanticipatedly releasing a cable pulling the body backwards, with loads corresponding to 6%, 8% and 10% of body mass. We found that the increasing as compared to the decreasing load sequence led to lower values of (a) displacement and (b) velocity of center of pressure, and of activation rate of the muscle gastrocnemius medialis across loads. Muscular activation onset latency decreased as a function increasing loads, but no significant effects of load sequence were found. These results lead to the conclusion that APRs to unanticipated perturbations are scaled from the association of somatosensory feedback signaling balance instability with feedforward control from postural responses to previous perturbations.

Design of an adjustable stance-control knee-ankle-foot orthosis for pediatric population.

Conventional knee-ankle-foot orthoses (KAFOs) are generally prescribed for children with lower limb muscle weakness and joint instabilities. The main function of KAFOs is to provide stability during gait by locking the knee in full extension. However, walking with the knee joint in a fully extended position requires excessive energy consumption, leading to early fatigue and inducing non-physiological gait patterns. A new generation of KAFOs was developed to allow free knee flexion during the swing phase and to lock the knee joint during the stance phase to provide the required stability. These are commonly labeled as stance-control knee-ankle-foot orthoses (SCKAFOs). Nevertheless, commercial SCKAFOs are not available for the pediatric population. Especially in early ages, children must frequently replace the orthosis due to their growth. Hence, the proposed design presents a solution for a SCKAFO with adjustable length adaptable to children's dimensions ranging from two to six years old.

Contribution of hip abductor-adductor muscles on static and dynamic balance of community-dwelling older adults.

BACKGROUND: The previous studies have investigated causes of and risk factors for falls and impairment of functional capability in older adults. However, the biomechanical factors involved in functional performance and postural control, and the contribution of hip muscles, are still unknown. AIMS: The aim of the present study was to verify the association between the muscle function of hip abductors and adductors and static and dynamic balance, in a narrow base of support, in community-dwelling older adults. METHODS: Eighty-one older adults, including both women and men, were evaluated. Tandem gait and single-leg stance were used to assess static and dynamic balance, and an isokinetic dynamometer was used to analyze muscle function (peak torque and rate of torque development according to body weight). Data were analyzed by a multivariate linear regression test without adjustment and with adjustment using two models: adjustment I (sex) and adjustment II (age). RESULTS: There was a statistically significant association between peak torque of abductor in single-leg stance and tandem gait speed. The PT of hip adductors contributed to static balance performance, in a narrow base of support from the unadjusted data and from the adjusted data by sex. CONCLUSION: The findings of the present study are relevant, because if deficits in balance and functionality in older adults can be linked to a decline in maximum muscle strength of hip abductors, this parameter can be treated to maintain independence in older adults for as long as possible.

The Biology and Evolution of the Three Psychological Tendencies to Anthropomorphize Biology and Evolution.

At the core of anthropomorphism lies a false positive cognitive bias to over-attribute the pattern of the human body and/or mind. Anthropomorphism is independently discussed in various disciplines, is presumed to have deep biological roots, but its cognitive bases are rarely explored in an integrative way. Conversely, I present an inclusive, multifaceted interdisciplinary approach to refine the psychological bases of mental anthropomorphism. I have integrated 13 conceptual dissections of folk finalistic reasoning into four psychological inference systems (physical, design, basic-goal, and belief stances); the latter three are truly teleological and thus prone to anthropomorphisms. I then have integrated the genetic, neural, cognitive, psychiatric, developmental, comparative and evolutionary/adaptive empirical evidence that converges to support the nature of the distinct stances. The over-reactive calibration of the three teleological systems prone to anthropomorphisms is framed as an evolved design feature to avoid harmful ancestral contexts. Nowadays, these stances easily engage with scientific reasoning about bio-evolutionary matters with both negative and positive consequences. Design, basic-goal, and belief stances benefit biology by providing cognitive foundations, expressing a high-powered explanatory system, promoting functional generalization, fostering new research questions and discoveries, enabling metaphorical/analogical thinking and explaining didactically with brevity. Hence, it is neither feasible nor advantageous to completely eliminate teleology from biology. Instead, we should engage with the eight classes of problems in bio-philosophy and bio-education that relate to the three stances: types of anthropomorphism, variety of misunderstandings, misleading appeal, legitimacy controversy, gateway to mysticism, total prohibition and its backfire effect. Recognizing the distinction among design, basic-goal, and belief stances helps to elucidate much of the logic underlying these issues, so that it enables a much more detailed taxonomy of anthropomorphisms, and organizes the various misunderstandings about evolution by natural selection. It also offers a solid psychological grounding for anchoring definitions and terminology. This tripartite framework also shed some light on how to better deal with the over-reactive stances in bio-education, by organizing previous pedagogical strategies and by suggesting new possibilities to be tested. Therefore, this framework constitutes a promising approach to advance the debate regarding the psychological underpinnings of anthropomorphisms and to further support regulating and clarifying teleology and anthropomorphism in biology.

Uso de enxerto autógeno de fáscia lata no tratamento de defeito segmentar crônico do tendão calcâneo comum em felino doméstico / Use of autogenous fascia lata graft in the treatment of chronic segmental defect of the common calcaneus tendon in domestic feline

Background: The common calcaneus tendon is formed by the common tendon of the femoral biceps muscle, tendon of the superficial digital flexor muscle and gastrocnemius muscle tendon, and its rupture is related to acute traumas in small animals. Among some applications described, surgical repair can be adopted in the correction of tendon ruptures and the use of grafts may be indicated in some severe lesions, where it is not possible to perform tenorrhaphy. This study aims to report the case of a feline with rupture of the common calcaneus tendon in which the tenorrafia associated with the autogenous fascia lata graft was performed as adjuvant to the cicatrization of the same.Case: A 24-month-old, undefined male feline with approximately 3 kg was treated at the FCAV Veterinary Hospital, UNESP Jaboticabal, State of São Paulo, Brazil, with a history of falling, for approximately two weeks, and has since plantigrade posture. Upon physical examination, it was possible to identify a discontinuity of the common calcaneus tendon. The radiographs were performed, which did not show any bone changes. A hemogram and biochemical profile were performed, which were within normal limits. The patient underwent surgery, and a complete lesion of the common calcaneus tendon was identified, with a chronic aspect. Approximation of the stumps was impossible, so a flap of fascia lata, about two centimeters long and one centimeter wide, was removed, which was used as a bed and tendon support for tendon growth. After removal all of the present fibrosis, the tendon stumps were approximated by means of modified Kessler suture with mononylon thread, and fascia lata flap of the ipsilateral limb was sutured with separate single points in both tendon ends and in their lateral and medial portion. In the tibiotarsic joint, the external skeletal fixator type II was used for immobilization, during a period of 30 days.[...](AU)

Uso de enxerto autógeno de fáscia lata no tratamento de defeito segmentar crônico do tendão calcâneo comum em felino doméstico / Use of autogenous fascia lata graft in the treatment of chronic segmental defect of the common calcaneus tendon in domestic feline

Background: The common calcaneus tendon is formed by the common tendon of the femoral biceps muscle, tendon of the superficial digital flexor muscle and gastrocnemius muscle tendon, and its rupture is related to acute traumas in small animals. Among some applications described, surgical repair can be adopted in the correction of tendon ruptures and the use of grafts may be indicated in some severe lesions, where it is not possible to perform tenorrhaphy. This study aims to report the case of a feline with rupture of the common calcaneus tendon in which the tenorrafia associated with the autogenous fascia lata graft was performed as adjuvant to the cicatrization of the same.Case: A 24-month-old, undefined male feline with approximately 3 kg was treated at the FCAV Veterinary Hospital, UNESP Jaboticabal, State of São Paulo, Brazil, with a history of falling, for approximately two weeks, and has since plantigrade posture. Upon physical examination, it was possible to identify a discontinuity of the common calcaneus tendon. The radiographs were performed, which did not show any bone changes. A hemogram and biochemical profile were performed, which were within normal limits. The patient underwent surgery, and a complete lesion of the common calcaneus tendon was identified, with a chronic aspect. Approximation of the stumps was impossible, so a flap of fascia lata, about two centimeters long and one centimeter wide, was removed, which was used as a bed and tendon support for tendon growth. After removal all of the present fibrosis, the tendon stumps were approximated by means of modified Kessler suture with mononylon thread, and fascia lata flap of the ipsilateral limb was sutured with separate single points in both tendon ends and in their lateral and medial portion. In the tibiotarsic joint, the external skeletal fixator type II was used for immobilization, during a period of 30 days.[...]

Effects of backpack loads and positions on the variability of gait spatiotemporal parameters in young adults

Abstract Introduction: People carry backpacks of different weight in different positions every day. The effects of backpack wearing under different loads and positions were assessed according to the gait's spatiotemporal parameters and their variability in young adults. Methods Twenty-one subjects performed trials of 4 min in the conditions: control condition with no backpack; bilateral back load consisting of 10% body weight (BW); bilateral back load of 20% BW (B20); unilateral load of 10% BW; unilateral load with 20% BW (U20); bilateral frontal load with 10% BW; bilateral frontal load with 20% BW. Results Step length (SL) and step frequency (SF) show that frontal conditions differed from others as seen in B20. Gait cycle phases showed an increase in the B20 condition for double stance phase and stance phase, swing phase presented reduction in the B20 condition. There were significant main effects in position for SL, SF, and walk ratio, in load only for stride width. The highest variability of spatiotemporal parameters occurred in the U20 condition. All load conditions with 20% BW showed a greater variability when compared to the 10% BW counterpart. Conclusion We concluded that young adults can cope with up to a 15% BW load under a bilateral back position, but in the frontal position not even a 10% BW load was proven to be a safe limit. 20% BW loads should be avoided in any position. These recommendations may assure increased gait stability, decreased trunk forward lean and decreased muscle activation and fatigue reducing back pain occurrence.

Postural Instability in Prodromal Spinocerebellar Ataxia Type 2: Insights into Cerebellar Involvement Before Onset of Permanent Ataxia

Studies on prodromal stage in spinocerebellar ataxias (SCAs) have become high priority approaches in view of their usefulness to detect biomarkers that herald the onset of permanent ataxia and assess the efficacy of future therapeutical trials [1]. The most comprehensive evaluation of prodromal SCA2 comes from the large and homogeneous population of Cuban preclinical carriers, which derives from a 13 years presymptomatic diagnostic program and the nationwide molecular epidemiological survey (AU)

Efectos del entrenamiento en superficies inestables sobre el equilibrio y funcionalidad en adultos mayores / Effect of training on an unstable balance and function in eldery people

OBJETIVO: determinar los efectos de un programa de ocho semanas de entrenamiento en superficies inestables con y sin trabajo de fuerza, sobre el equilibrio y la capacidad funcional en adultos mayores de 60 años, pertenecientes al programa "Escuelas populares del deporte" del INDER Medellín. METODOLOGIA: se llevó a cabo un estudio experimental simple, ciego y enmascarado con asignación al azar de 34 sujetos a dos grupos de intervención con y sin trabajo de fuerza sobre superficies inestables; se midió el equilibrio unipodal, bipodal con ojos abiertos y cerrados, además de pruebas funcionales como Up and Go, arm curl y chair test. RESULTADOS:las intervenciones con y sin trabajo de fuerza mejoraron el equilibrio total en 57,0 y 69,5 segundos respectivamente, sin diferencias estadísticamente significativas en la comparación entre los grupos (p= 0,13). Se mejoró la velocidad de la marcha con ambas intervenciones sin diferencias intragrupos estadísticamente significativas (p= 0,33) pero importantes para la práctica. CONCLUSION: ambas intervenciones mejoran el equilibrio, sin embargo existen diferencias importantes para la práctica a favor del programa sobre superficies inestables sin trabajo de fuerza, pues la intervención tiene un mejor efecto sobre el equilibrio unipodal y bipodal tanto con ojos abiertos como con cerrados.

OBJECTIVE:to determine the effects of an eight-week training program on unstable surfaces with and without strength work regarding balance and functional capacity in adults over 60 who belong to the inder sport schools program in Medellín. METHODOLOGY: simple single-blind and masked experimental trials were conducted on 34 subjects who were randomly assigned to two intervention groups with and without strength work on unstable surfaces. Unipodal and bipodal balance was measured while the subjects' eyes were open and closed. In addition, functional tests such as Up and Go, Arm Curl and Chair Test were conducted. RESULTS : interventions with and without strength work improved total balance in 57.0 and 69.5 seconds respectively. The differences between the groups were not statistically significant (p = 0.33), nonetheless they were important. CONCLUSION: both interventions improve balance, however there are differences that are important in practice. These differences favor the program involving unstable surfaces without an unstable without strength work because the intervention has a better effect on unipodal and bipodal balance both with open and closed eyes.

A construção de uma relação de casal - uma relação de casal em construção / The construction of a couple relationship - a couple relationship under construction

Este artigo originou-se do trabalho de conclusão do curso em Terapia de Família e Casal do Instituto Familiae, em que a autora a partir da pergunta: É possível uma relação de casal estável em um mundo em mudança? Foram entrevistados casais que mantêm relações longevas. As reflexões sobre os relatos dos entrevistados motivaram a busca na História sobre a compreensão de como a sociedade foi se organizando em relação ao casamento. As entrevistas e o estudo sobre o percurso histórico das relações de casal indicam as relações de casal como constituídas culturalmente e em transformação ao longo do tempo, originando o título: “A construção de uma relação de casal – uma relação de casal em construção”. A autora convida a uma reflexão sobre a importância de que o terapeuta de casal cuide para que suas crenças e certezas não se sobreponham às narrativas dos membros do casal.(AU)

This article summarizes the author’s final paper for her training course for Families and Couples Therapy in the Familiae Institute, São Paulo. Beginning with the question: Is it possible for couples to sustain stable marriage in an ever changing world?, the author interviewed couples living long term relationships. Reflections about the narratives obtained from the interviews invited her to search for the understanding in History about marriage social organizations. Both interviews and the history of marriage point to the cultural constitution of these relationships and its transformation through time. These findings led her to choose the title of this article: “The construction of a couple’s relationship – a couple’s relationship in construction.” The author invites the readers to reflect about the importance for couple therapists not to let his/hers beliefs and truths to superimpose the couple’s ones.(AU)

O enquadramento do aborto na mídia impressa brasileira nas eleições 2010: a exclusão da saúde pública do debate / The stance of abortion in the Brazilian printed media ahead of the 2010 presidential elections: the exclusion of public health from the debate

OBJETIVOS: o artigo apresenta os resultados de uma pesquisa de monitoramento da mídia impressa brasileira para identificar as formas de enquadramento do tema do aborto durante o período de 6 de julho a 29 de outubro de 2010, período oficial da campanha eleitoral para a Presidência da República. METODOLOGIA: a partir do monitoramento de 28 veículos impressos de circulação nacional (jornais e revistas), a pesquisa recuperou 464 textos, dos quais 434 foram considerados válidos para o estudo, entre matérias, reportagens, notas, colunas de opinião, entrevistas e cartas de leitores. RESULTADOS: embora o aborto tenha sido amplamente citado na cobertura jornalística da mídia impressa brasileira durante a campanha eleitoral para a Presidência da República em 2010, em uma média de 4 textos publicados por dia, o enquadramento adotado para o tema não foi o da perspectiva da saúde pública. Dos 434 textos analisados, apenas 1 reportagem abordou explicitamente dados epidemiológicos relacionando o aborto à saúde da mulher. Nos demais textos, o agendamento do tema foi pautado mediante enquadramentos eleitorais associando-o à disputa dos candidatos pelos votos das comunidades religiosas e do eleitorado conservador.

OBJECTIVES: this article presents the results of research to monitor the Brazilian printed media in order to identify the stance of the abortion issue during the period from July 6 to October 29, 2010, which was the period of the official presidential campaign in Brazil. METHODOLOGY: based on the monitoring of 28 printed media vehicles (newspapers and magazines) with nationwide circulation, the research selected 464 texts, of which 434 were considered valid for the study. The media studied included stories, reports, notes, opinion columns, interviews and letters from readers. RESULTS: although abortion was widely mentioned in Brazilian news coverage of the presidential campaign in 2010, with an average of four texts published per day, the stance adopted for the issue was not from the standpoint of public health. Among the 434 texts analyzed, only one report explicitly addressed epidemiological data linking abortion to women's health. In the other texts, the positioning of abortion was guided by the electoral stance that associated it with the dispute for the votes of the religious communities and conservative voters.

El niño homicida: La estirpe de Caín. Un estudio psicoanalítico / The murder child: Cain’s lineage. A psychoan-alytical study / L’enfant meurtrier: la lignee de caïn. Une etude psychanalytique

El artículo, es el informe de una investigación realizada en la Universidad de Antioquia sobre el fenómeno que se ha producido en Colombia en los últimos años, según el cual muchachos cada vez más jóvenes se comprometen en actos homi-cidas, con los cuales establecen un circuito a repetición en el que matan y se hacen matar ante la mirada perpleja del sistema jurídico. La inves-tigación, sirviéndose del psicoanálisis, se propu-so, no solamente intentar explicar el circuito mor-tífero, sino además producir una propuesta de intervención en la cual sea posible escuchar estos jóvenes, darles un lugar en el dispositivo jurídico que, permitiéndoles hacerse responsable de su acto, logre allanar su camino hacia la muer-te y favorezca el restablecimiento del lazo social...

The article is the research report from the Univer-sity of Antioquia about phenomenon in Colombia the last years, according to which younger and younger boys come into murder acts, establishing a repetitive circuit where they kill and are killed before the perplexed gaze of the legal system. Using the psychoanalysis, the research proposes to try to explain the deadly circuit as well as to produce an intervention answer, making possible to listen these young people and giving them a place inside the legal device –also allowing them become responsible for their acts– that achieve to calm their rush towards the death, and offering the reestablishment of the social fabric...

Ceci est le rapport d’une recherche menée à l’Université d’Antioquia sur le phénomène produit en Colombie les dernières années, où des enfants de plus en plus jeunes s’engagent dans des meurtres, en établissant un circuit de répétition où ils tuent et se font tuer face au regard perplexe du système juridique. Cette recherche,, en se servant de la psychanalyse, s’est proposée non seulement de tenter d’expliquer le circuit meurtrier mais aussi de produire une proposition d’intervention où il soit possible d’écouter ces jeunes, de leur donner une place à l’intérieur du dispositif juridique qui, en leur permettant de se faire responsables de leurs actes, réussisse à surmonter leur chemin vers la mort, et soit favorable au rétablissement du lien social...

Trascender los dilemas del poder y del terapeuta como experto en la psicoterapia sistémica / Beyond the dilemmas of power and of the therapist as expert in systemic psychotherapy

Este artículo analiza someramente la forma como tres modelos contemporáneos de terapia sistémica explican el rol del terapeuta en el cambio que se activa en el proceso de ayuda. Se toman como referentes principales la relación de poder inherente a la terapia, el saber del terapeuta y su estilo directivo o simétrico con respecto a los consultantes. Se propone la opción de que el terapeuta asuma una postura de "paramodernidad" para trascender los dilemas que le plantea su función y admita que sus preferencias teóricas deben guiarse por el imperativo ético de generar un contexto donde los consultantes logren ampliar su margen de libertad, limitado por los síntomas y los conflictos interpersonales que constituyen los motivos de consulta.

This article briefly analyzes, how three contempory family therapy models explain role of the therapist in the process of change in therapy. The principal referents of analysis, the power relationship inherent to therapy, the therapist’s knowledge, and his/her directive or symmetric with regards respect to the consultants. It proposes that the therapist could assume a “paramodern” stance to go beyond the dilemmas of his/her social function and accept that his/her theoretical preferences must be founded on an ethical imperative to generate a context, where the consultants expandtheir margin of freedom, which is limited by the symptoms and the interpersonal conflicts presented as complaints.