RESUMO

INTRODUCTION: After anterior cruciate ligament (ACL) reconstruction, determining readiness to return to participation is challenging. The understanding of which neuromuscular performance parameters are associated with limb symmetry and self-reported symptoms may be useful to improve monitoring the rehabilitation towards adequate decision-making to return. OBJECTIVES: To compare the ACL-operated and injury-free lower limbs regarding functional performance; and to investigate whether lower limb strength and functional performance are associated with self-reported symptoms and functional lower limb symmetry. METHOD: Thirty-four participants were included. Functional performance was assessed by using the Y-Balance test, Single-leg Hop, and Functional Movement Screen. An isokinetic dynamometer was used to evaluate the strength levels in open and closed kinetic chains. The functional lower limb symmetry was calculated considering the single-leg hop test results for each lower limb. RESULTS: There were no differences in dynamic balance (Y-Balance) between the operated and injury-free limbs. The operated limb presented a worst performance in the single-leg hop. Self-reported symptoms prevalence and lower limb symmetry were associated with knee extension strength and functional performance (Y-Balance). CONCLUSION: Individuals submitted to ACL-reconstruction presented worse functional performance in the operated limb compared to the injury-free limb. Both knee strength and dynamic balance were associated with limb symmetry and self-reported symptoms.

Assuntos

RESUMO

INTRODUCTION: Previous studies have highlighted the association between lower limb muscle strength and falls in older adults. However, a comprehensive understanding of the specific influence of each lower limb muscle group on fall occurrences remains lacking. OBJECTIVE: This study aimed to investigate the impact of knee, ankle, and hip muscle strength and power on falls in older adults, with the goal of identifying which muscle groups are more predictive of fall risk in this population. METHODS: This longitudinal observational study enrolled 94 community-dwelling older adults. Muscle strength and power of the ankle's plantiflexors and dorsiflexors, knee flexors and extensors, and hip flexors, extensors, adductors, and abductors were assessed using a Biodex System 4 Pro® isokinetic dynamometer. Fall occurrences were monitored through monthly telephone contact over a year. RESULTS: Participants, with a median age of 69 years (range 64-74), included 67% women, and 63.8% reported a sedentary lifestyle. Among them, 45,7% of older adults were classified as fallers. Comparative analyses revealed that non-fallers displayed significantly superior isokinetic muscle strength in the hip abductors and adductors, along with higher muscle power in the hip abductors, hip flexors, and knee flexors compared to fallers. Multivariate logistic regression analysis indicated that a 1 Nm/Kg increase in hip abductor strength reduced the chance of a fall by 86.3%, and a 1 Watt increase in hip flexor power reduced the chance of a fall by 3.6%. CONCLUSION: The findings indicate that hip abductor strength and hip flexor power can be considered protective factors against falls in independent older adults in the community. These findings may contribute to developing effective fall-prevention strategies for this population.

Assuntos

RESUMO

ABSTRACT This study aimed to investigate the contributions of social participation in health promotion groups and regular physical exercise programs to the physical and functional performance of different age groups of community-dwelling older adults. This is a cross-sectional study including 266 older adults. Physical and functional performances (dependent variables) were characterized based on dynamic balance (alternate step test), mobility (timed up and go test), upper (handgrip dynamometer) and lower limbs muscle strength (Sit-to-stand test). Participants were questioned about active social participation in primary care groups and in physical exercise programs. The data were analyzed by linear regressions. Among individuals aged over 80 years, women participated in less health promotion groups and both sexes practiced less physical exercise. Age combined with regular exercise significantly explained 18.7% of dynamic balance and 22.8% of lower limb muscle strength in women. Despite social participation, for men, age alone explained 11.9% of lower limb strength and 11.5% of mobility. Therefore, social participation in physical exercise programs was a protective factor for these physical and functional differences between women's age groups. Among men, mobility and lower limb strength performance reduced with aging, regardless of social participation.

RESUMO O objetivo deste estudo foi investigar as contribuições da participação social em grupos de promoção de saúde e programas de exercícios físicos regulares para o desempenho físico e funcional de idosos comunitários de diferentes faixas etárias. Para tanto, realizou-se um estudo transversal com 266 idosos. O desempenho físico e funcional (variáveis dependentes) foi caracterizado com base no equilíbrio dinâmico (teste de degrau alternado), na mobilidade (teste timed up and go), na força muscular dos membros superiores (dinamômetro de preensão manual) e inferiores (teste de sentar e levantar). Os participantes foram questionados sobre sua participação social ativa em grupos de atenção primária e em programas de exercícios físicos. Os dados foram analisados por regressões lineares. Entre os indivíduos com 80 anos ou mais, as mulheres participaram menos de grupos de promoção de saúde, e ambos os sexos praticaram menos exercícios físicos. A idade combinada com o exercício regular explicou significativamente 18,7% do equilíbrio dinâmico e 22,8% da força muscular dos membros inferiores em mulheres. Para os participantes do sexo masculino, independentemente da participação social, apenas a idade explicou 11,9% da força dos membros inferiores e 11,5% da mobilidade. Verificou-se que a participação social em programas de exercícios físicos foi um fator protetor, entre as mulheres, para essas diferenças físicas e funcionais entre faixas etárias. Entre os homens, o desempenho de mobilidade e força dos membros inferiores foi piorando conforme o aumento da idade, independentemente da participação social.

RESUMEN El objetivo de este estudio fue investigar las contribuciones de la participación social en grupos de promoción de la salud y en programas de ejercicio físico regular para el desempeño físico y funcional de ancianos residentes en comunidad de diferentes grupos de edad. Para ello, se realizó un estudio transversal con 266 ancianos. El rendimiento físico y funcional (variables dependientes) se caracterizó con base en el equilibrio dinámico (prueba de escalón alterno), en la movilidad (prueba timed up and go), en la fuerza muscular de los miembros superiores (dinamómetro de agarre manual) y miembros inferiores (prueba de levantarse y sentarse). Las preguntas del cuestionario versaban sobre la participación social activa de los encuestados en grupos de atención primaria y en programas de ejercicio físico. Los datos se analizaron mediante regresiones lineales. Entre las personas de 80 años o más, las mujeres participaban menos en los grupos de promoción de la salud y ambos sexos practicaban menos ejercicio físico. La combinación edad y ejercicio regular explicó significativamente el 18,7% del equilibrio dinámico y el 22,8% de la fuerza muscular de los miembros inferiores en las mujeres. Para los participantes del sexo masculino, independientemente de la participación social, la edad por sí sola explicó el 11,9% de la fuerza de los miembros inferiores y el 11,5% de la movilidad. Se encontró que la participación social en programas de ejercicio físico fue un factor protector entre las mujeres para estas diferencias físicas y funcionales entre los grupos de edad. Entre los hombres, el rendimiento de la movilidad y fuerza de las extremidades inferiores empeoró conforme el aumento de la edad, independientemente de la participación social.

RESUMO

ABSTRACT Previous studies have shown an association between lower limb muscle strength and functional performance, but a dose-response relationship between the strength of each lower limb muscle group and performance in daily life activities in older adults has not been well established. Thus, this study aimed to investigate the association between isokinetic muscle strength of all eight major lower limb muscle groups and functional performance in community-dwelling older adults. The muscle strength of the plantar flexors and dorsiflexors of the ankle, flexors and extensors of the knee, and flexors, extensors, adductors, and abductors of the hip were evaluated using a Biodex System 4 Pro® isokinetic dynamometer. Functional performance was evaluated in 109 participants using the five-times sit-to-stand test (STS) and 4-meter usual walking speed (UWS). The multiple linear regression analyses showed that the hip abductors strength predicted 31.3% of the variability for UWS (p=0.011), and the knee extensors strength (p=0.015) predicted 31.6% of the variability for the STS. We conclude that hip abductors and knee extensors could be the key muscle groups involved in sit to stand and walking speed performance in older adults.

RESUMEN Estudios previos ya demostraron la asociación entre la fuerza muscular de los miembros inferiores y el rendimiento funcional, sin embargo, no está bien establecida la contribución de los principales músculos de los miembros inferiores sobre el rendimiento de las personas mayores en las actividades diarias. El objetivo de este estudio fue evaluar la asociación entre la fuerza muscular isocinética de los ocho principales grupos musculares de los miembros inferiores y el rendimiento funcional en personas mayores que viven en la comunidad. La fuerza muscular de los plantiflexores y dorsiflexores del tobillo, los flexores y extensores de la rodilla y los flexores, extensores, aductores y abductores de la cadera se evaluaron por medio del dinamómetro isocinético Biodex System 4 Pro®. El rendimiento funcional de 109 participantes se evaluó mediante el test de sentarse y pararse cinco veces (STS) y la velocidad de marcha habitual de 4 metros. Los análisis de regresión lineal múltiple mostraron que la fuerza de los abductores de la cadera predijo el 31,3% de la variabilidad para la velocidad de marcha habitual (p=0,011); y la fuerza de los extensores de la rodilla (p=0,015), el 31,6% de variabilidad para STS. Se concluyó que los abductores de la cadera y los extensores de la rodilla pueden ser los principales grupos musculares involucrados en el rendimiento de los adultos mayores para sentarse, pararse y caminar.

RESUMO Estudos anteriores já demonstraram a associação entre força muscular de membros inferiores e desempenho funcional, mas a contribuição dos principais músculos dos membros inferiores para o desempenho de pessoas idosas nas atividades cotidianas não foi bem estabelecida. O objetivo deste estudo foi investigar a associação entre a força muscular isocinética dos oito principais grupos musculares dos membros inferiores e o desempenho funcional em pessoas idosas da comunidade. A força muscular dos plantiflexores e dorsiflexores do tornozelo, flexores e extensores do joelho e flexores, extensores, adutores e abdutores do quadril foi avaliada utilizando um dinamômetro isocinético Biodex System 4 Pro®. O desempenho funcional de 109 participantes foi avaliado usando o teste de sentar e levantar cinco vezes (TSL) e de velocidade de marcha habitual de 4 metros (VMH). As análises de regressão linear múltipla mostraram que a força dos abdutores do quadril previu 31,3% da variabilidade para a VMH (p=0,011), e a força dos extensores do joelho (p=0,015) 31,6% da variabilidade para o TSL. Concluímos que os abdutores do quadril e os extensores do joelho podem ser os principais grupos musculares envolvidos no desempenho de pessoas idosas para sentar-levantar e caminhar.

RESUMO

RESUMO O objetivo deste estudo é analisar a satisfação e distorção da imagem corporal em crianças de 7 a 10 anos de idade e verificar quais fatores antropométricos e socioeconômicos estão associados a elas. Trata-se de um estudo transversal, realizado com 307 crianças de escolas públicas de Goiânia. A saúde da criança e os aspectos socioeconômicos da família foram avaliados por meio de um questionário semiestruturado; a imagem corporal foi avaliada por meio da Escala de Silhuetas Brasileiras Para Crianças; e também foram coletados dados antropométricos de peso, estatura, dobras cutâneas e circunferência da cintura. Observou-se homogeneidade do gênero neste estudo, predomínio de meninos (52%) eutróficos (73%). Apesar de se tratar de uma amostra com peso saudável, a insatisfação e a distorção da imagem corporal prevaleceram sobre a maior parte da amostra: a insatisfação esteve presente em 92% das crianças, prevalecendo o desejo por uma menor silhueta, enquanto a distorção esteve presente em 75% da amostra, com predomínio da subestimação da silhueta. No entanto, este estudo encontrou associação da insatisfação com a imagem corporal apenas com IMC (aferido, atual e desejado) e circunferência da cintura; e associação da distorção da imagem corporal apenas com os IMC (aferido e atual).

ABSTRACT The aim of this study is to analyze the satisfaction and distortion of body image in children from 7 to 10 years old and to verify which anthropometric and socioeconomic factors are associated with them. This is a cross-sectional study, carried out with 307 children from public schools in Goiânia. The child's health and the socioeconomic aspects of the family were assessed using a semi-structured questionnaire; body image was assessed using the Brazilian Silhouettes Scale for Children; and anthropometric data on weight, height, skinfolds and waist circumference were also collected. Gender homogeneity was observed in this study, with a predominance of eutrophic(73%) boys (52%). Despite being a sample with a healthy weight, dissatisfaction and distortion of body image prevailed over most of the sample: dissatisfaction was present in 92% of children, the desire for a smaller silhouette prevailing, while distortion was present in 75% of the sample, with a predominance of underestimation of the silhouette. However, this study found dissatisfaction association with body image only with BMI (measured, current and desired) and waist circumference; and association of the distortion of the body image only with the BMI (measured and current).

Assuntos

RESUMO

INTRODUCTION: Electronic devices have been used by increasingly younger people, leading researchers to investigate the impact of these technologies on the health of developing childrenOBJECTIVE: To investigate the impact of smartphone use on the postural control of Brazilian children 6 to 9 years oldMETHODS: This cross-sectional study was conducted with 278 children from public schools in Goiânia (Goiás, Brazil). The children were assessed in an orthostatic posture with the computerized baropodometry system in three conditions: eyes open, eyes closed, and using a free smartphone applicationRESULTS: The children were 8.36 years old on average, 82% of them were well-nourished, and had a daily mean screen time of 2 hours. The postural control analyses revealed that the children made greater postural adjustments with their eyes closed than with them open. When using the smartphone application, the postural adjustments were similar to those with eyes closed. In the stabilometry, the postural displacements made by the children behaved similarly to the static assessment only in total feet surface areaCONCLUSION: Smartphone use and absence of visual stimulus in the orthostatic position caused postural instability in children 6 to 9 years old. These findings can contribute to understanding the impact of technologies on children's development of balance in daily tasks

INTRODUÇÃO: O uso de dispositivos eletrônicos móveis tem alcançado usuários cada vez mais jovens e tem levado pesquisadores a investigar o impacto dessas tecnologias na saúde da criança em desenvolvimentoOBJETIVO: Investigar o impacto do uso do smartphone no controle postural de crianças brasileiras de 6 a 9 anos de idadeMÉTODO: Estudo transversal realizado com 278 crianças de escolas públicas de Goiânia (GO, Brasil). As crianças foram avaliadas na postura ortostática pelo sistema de baropodometria computadorizada em três condições: olhos abertos, olhos fechados e manuseando um aplicativo gratuito para smartphoneRESULTADOS: As crianças tinham idade média de 8,36 anos, sendo 82% de eutróficas e com tempo médio de tela de duas horas diárias. As análises do controle postural revelaram que as crianças apresentaram maiores ajustes posturais com os olhos fechados em comparação com os olhos abertos e ao usar o aplicativo do smartphone o ajuste postural foi semelhante ao encontrado com olhos fechados. Na estabilometria, os deslocamentos posturais realizados pelas crianças se comportaram de modo semelhante à avaliação estática apenas na área total da superfície dos pésCONCLUSÃO: O uso do smartphone e a ausência do estímulo visual na posição ortostática promoveram instabilidade postural nas crianças de 6 a 9 anos de idade. Estes achados podem contribuir para o conhecimento do impacto de tecnologias no desenvolvimento do equilíbrio de crianças em atividades diárias

Assuntos

RESUMO

O objetivo do estudo foi verificar a influência do estímulo visual e posicionamento dos membros superiores no controle postural ortostático e avaliar o efeito do sexo e idade nas respostas posturais de crianças e adolescentes. Estudo transversal, com amostra de 84 participantes com idade entre 11 e 14 anos, ambos os sexos (55 meninas), de escola pública de Goiânia (GO). Além do exame físico, o controle postural foi avaliado na posição ortostática pela baropodometria computadorizada em três condições: olhos abertos, olhos fechados e olhos abertos com ombros a 90° de abdução. A ausência do estímulo visual gerou maior instabilidade postural em comparação à condição de olhos abertos. Em relação as diferenças existentes entre os sexos, foi observado que as meninas tiveram menores valores de deslocamento anteroposterior e área da elipse que os meninos. Comparando-se os olhos abertos e fechados, as meninas apresentaram maiores valores na área da elipse e os meninos nos deslocamentos anteroposterior e látero-lateral. Ao analisar o efeito da idade foi observado que o grupo com 13 e 14 anos apresentou maiores valores em todas as variáveis analisadas. A ausência do estímulo visual aumentou os valores da área da elipse no grupo com 11 e 12 e dos deslocamentos no grupo com 13 e 14 anos. Não foi verificado efeito interativo entre sexo e idade. Na condição de abdução dos membros superiores não houve diferença no controle postural. Conclui-se que a ausência do estímulo visual foi mais impactante na manutenção do controle postural ortostático em crianças e adolescentes em relação as outras condições avaliadas, existindo diferença entre os sexos e a idade, em que os meninos e o grupo com 13 e 14 anos realizaram mais ajustes para manter o controle postural. (AU)

The aim of this study was to verify the influence of visual stimulus and positioning of the upper limbs in the orthostatic postural control, and to assess the effects of gender and age in the postural responses of children and adolescents. This was a transversal study involving 84 participants (of which 55 were girls) from public schools in Goiania (GO - Brazil) with age between 11 and 14 years. Besides physical examination, the participants' postural control was assessed in the orthostatic position by computerized baropodometry in three different conditions: eyes-open, eyes-closed, and eyes-open with shoulders at 90º abduction. The absence of visual stimulus generated more postural instability in relation to the eyes-open condition. Regarding gender differences, the girls had lower anteroposterior and ellipse area displacement than boys. Comparing the eyes-open and eyes-closed conditions, the girls presented higher values in the ellipse area and the boys presented higher values in the anteroposterior and laterolateral displacements. Analyzing the effect of age, the participants between 13 and 14 years old presented higher values in all variables. The absence of visual stimulus increased the values of the ellipse area in the participants between 11 and 12 years of age and the values of displacements in the participants between 13 and 14 years of age. Interactive effect between genders and age has not been verified. There were no postural control differences in the upper limbs abduction condition. Conclusion: The absence of visual stimulus was more impacting in the support of orthostatic postural control in children and adolescents than the other conditions assessed; the boys and the participants between 13 and 14 years of age made more adjustments in order to maintain postural control. (AU)

Assuntos

RESUMO

RESUMO O objetivo deste estudo foi avaliar o perfil de formação e produção científica do fisioterapeuta pesquisador brasileiro. Trata-se de um estudo transversal, realizado por meio de levantamento dos currículos profissionais cadastrados na Plataforma Lattes do Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), atualizados nos últimos 5 anos. As principais variáveis analisadas foram sexo, distribuição dos fisioterapeutas pelo Brasil, tipo de instituição de graduação, local de atuação, formação complementar, produções científicas e participação em eventos. Foram encontrados 47.741 currículos, dos quais 17.864 estavam dentro dos critérios de seleção da pesquisa e foram analisados. Predominaram fisioterapeutas do sexo feminino (75,5%) e da região Sudeste (35%). A maioria é graduada em instituições privadas (75%), realizou pós-graduação lato sensu (61,4%) e trabalhou em universidades (30%). Existem diferenças entre os sexos com relação às produções, os eventos e a formação complementar, com o melhor desempenho do sexo masculino (p<0,001) - os graduados em instituição pública têm mais produções, eventos e atividades de formação complementar (p<0,001). Os profissionais graduados em instituições privadas, porém, realizam mais cursos de pós-graduação lato sensu (p=0,05). Conclui-se, portanto, que a maioria dos fisioterapeutas pesquisadores do Brasil é do sexo feminino, graduada na região Sudeste, formada em instituições privadas, realizou pós-graduação lato sensu e trabalha em universidades. Apesar da maioria feminina, os profissionais do sexo masculino e os formados em instituições públicas apresentam maior quantidade de produções, participações em eventos e formações complementares.

resumen está disponible en el texto completo

ABSTRACT To evaluate the academic background and scientific productions' profile of researcher physiotherapists in Brazil. The study was cross-sectional in design and performed by analyzing the professional resumes that have been updated within the last 5 years in the Lattes Platform of the Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq). The main variables analyzed were sex, geographical distribution, kind of undergraduate institution, working location, complementary training, scientific production, and participation in events. The analysis was carried out on 17,864 curricula which were within the selection criteria, out of a total of 47,741. There was a predominance of female therapists (75.5%) and therapists from the southeast region (35%). Most have completed their undergraduate degree in private institutions (75%) and graduate programs (61.4%), and work at universities (30%). Males perform better (p<0.001) in scientific productions, participation in events, and complementary training activities. Graduates from public institutions have more scientific productions, events, and complementary training activities (p<0.001). However, professionals that have completed their undergraduate degree in private institutions do graduate programs the most (p=0.05). Most researcher physical therapists in Brazil are females, have completed their undergraduate degrees in the Southeast region and in private institutions, have completed graduate programs and work in universities. Despite the female predominance, male professionals and those therapists who have completed their undergraduate degree from public institutions have a greater amount of scientific productions, participation in events and complementary degrees.

RESUMO

BACKGROUND: There are inconsistent findings regarding the relationship between body mass index (BMI), fear of falling and body balance, especially on unstable surfaces. OBJECTIVES: To investigate whether obesity is associated with worse postural balance and fear of falling in older adults. METHODS: A cross-sectional study was conducted with 201 older adults, classified as normal weight, overweight, or obese according to BMI. Postural balance was evaluated on stable and unstable surfaces on the Biodex Balance System platform under three visual conditions: with and without visual feedback and with eyes closed. Fear of falling was identified by a dichotomous question and the Falls Efficacy Scale. These data were compared between groups and included in adjusted multiple linear regression analysis. RESULTS: The study showed no significant differences (p > 0.05) in body oscillations on a stable surface between the three groups. On an unstable surface, the obese older adults exhibited body oscillations from 0.61° [95% CI 0.07, 1.30] to 1.63° [95% CI 0.84, 2.41] greater than those with normal weight in the three visual conditions. The obese older adults also displayed larger mediolateral oscillations with visual feedback (mean difference: 0.50° [95% CI 0.01, 0.98]) as well as greater global oscillations without visual feedback (mean difference of 0.82° [95% CI 0.18, 1.81]) and with progressive instability (mean difference: 0.80° [95% CI 0.05, 1.66]) than the overweight older adults. BMI explained from 6 to 12% of body swings investigated on unstable surface. Obesity was not associated with fear of falling. CONCLUSION: Obesity was associated with reduced postural stability on unstable surfaces but not with fear of falling in older adults.

Assuntos

RESUMO

Abstract Aims: This study aimed to analyze the intra- and inter-rater reliability in the assessment and classification of the longitudinal plantar arch of children from 6 to 10 years old in the eyes-open (EO) testing condition. Methods: A total of two-hundred and seventy-eight Brazilian children (556 feet), boys and girls, from 6 to 10 years of age participated in the study. The children's feet were examined on a baropodometric platform, and the Staheli index was used for calculating the plantar arch index. Footprint analyses were performed at two different times, with an interval of 7 to 10 days, by three physical therapists in a single testing condition, resulting in 3,336 footprints. To determine the reliability of the continuous measurements, the Intraclass Correlation Coefficients (ICC) with 95% confidence intervals (CIs), Standard error of the mean (SEM), absolute value and percentage, and the Minimum Detectable Change (MDC) were calculated. To determine the reliability of the longitudinal arch classification, inter-rater reliability was evaluated by Weighted Fleiss Kappa Coefficient and the test-retest reliability was estimated by Weighted Cohen Kappa Coefficient. Results: Regarding inter-rater reliability, we observed values of ICC ranging from 0.79 to 0.96; thus, the results were classified as substantial to excellent reliability), being the lowest ICC values occur for line B, mainly in the first assessments. SEM ranges from 0.08 to 0.21 (percentage: 3.74 to 28.7), being the best, the lowest SEM values occur for Plantar Arch Index assessments and the MDC varies between 0.22 and 0.59. Regarding intra-rater reliability, the results indicated excellent reliability: values of ICC range from 0.92 to 0.99, being the lowest ICC values also occurs for line B analysis. SEM ranges from 0.03 to 0.20 (percentage: 2.32 to 26.6), being the lowest SEM values occur for Plantar Arch Index assessments and MDC varies between 0.09 and 0.54. Analyzing the inter-rater reliability for the longitudinal arch classifications, we observed values of Weighted Fleiss Kappa Coefficient ranging from 0.83 to 0.87, expressing almost perfect agreement among the raters before and after evaluations. The test-retest reliability of the longitudinal arch classification resulted in values of Weighted Cohen Kappa Coefficient ranging from 0.80 to 0.996, expressing substantial to almost perfect agreement intra-rater. Conclusion: The study showed high reliability in the clinical assessment of the longitudinal plantar arch index of children from 6 to 10 years of age indicating that the Staheli method is applicable to pressure platform assessments with intra- and inter-rate reliability.

Assuntos