RESUMO
BACKGROUND: Sensory information obtained from the visual, somatosensory, and vestibular systems is responsible for regulating postural control, and if damage occurs in one or more of these sensory systems, postural control may be altered. OBJECTIVE: To evaluate and compare the postural sway velocity between children with normal hearing and with sensorineural hearing loss (SNHL), matched by sex and age group, and to compare the postural sway velocity between children with normal hearing and with SNHL, with and without vestibular dysfunction. METHODS: Cross-sectional study that evaluated 130 children (65 with normal hearing and 65 with SNHL), of both sexes and aged between 7 and 11 years, from public schools of the city of Caruaru, Pernambuco state, Brazil. The postural sway velocity of the center of pressure (COP) was assessed by a force platform, in two directions, anteroposterior (AP) and mediolateral (ML)), in three positions, namely bipedal support with feet together and parallel (parallel feet (PF)), bipedal support with one foot in front of the other (tandem foot (TF)), and single-leg support (one foot (OF)), evaluated with the eyes open and closed. RESULTS: Children with SNHL demonstrated greater postural sway velocity compared to children with normal hearing in all the positions evaluated, with significant differences in the AP direction, with the eyes open (PF: p = 0.001; TF: p = 0.000; OF: p = 0.003) and closed (PF: p = 0.050; TF: p = 0.005). The same occurred in the ML direction, with the eyes open (PF: p = 0.001; TF: p = 0.000; OF: p = 0.001) and closed (PF: p = 0.002; TF: p = 0.000). The same occurred in relation to vestibular function, where the children with SNHL with an associated vestibular dysfunction demonstrated greater postural sway velocity compared to children with normal hearing in all the positions evaluated, demonstrating significant differences in the AP direction, with the eyes open (TF: p = 0.001; OF: p = 0.029) and eyes closed (PF: p = 0.036; TF: p = 0.033). The same occurred in the ML direction, with the eyes open (TF: p = 0.000) and with the eyes closed (PF: p = 0.008; TF: p = 0.009). CONCLUSIONS: Children with SNHL demonstrated greater instability of postural control than children with normal hearing in all the directions assessed. Children with SNHL and an associated vestibular dysfunction demonstrated the greatest instability of postural control in this study.
Assuntos
Equilíbrio Postural , Doenças Vestibulares , Humanos , Criança , Equilíbrio Postural/fisiologia , Masculino , Feminino , Estudos Transversais , Doenças Vestibulares/fisiopatologia , Perda Auditiva Neurossensorial/fisiopatologia , Surdez/fisiopatologiaRESUMO
OBJECTIVE: The purpose of this study was to assess the static balance of children with sensorineural hearing loss (SNHL) according to the degrees of SNHL and the function of the vestibular system. METHODS: This cross-sectional study was conducted in public schools located in Caruaru, Pernambuco state, Brazil, with 130 children (65 with normal hearing and 65 with SNHL as documented by air and bone conduction audiometry) of both sexes between 7 and 11 years old. Static balance was assessed by a stabilometric analysis using a force platform consisting of the circular area of center-of-pressure displacement of the children evaluated in 3 positions: bipedal support with feet together and parallel (PF), tandem feet (TF), and 1 foot (OF), carried out under 2 sensory conditions each, with eyes open and eyes closed. After balance assessments, the children with SNHL received examinations of auditory and vestibular functions-through audiometry and computerized vectoelectronystagmography, respectively-to compose the groups according to degrees of SNHL and vestibular function. RESULTS: The children with severe and profound SNHL demonstrated more static balance instabilities than the children with normal hearing in 5 positions assessed with eyes open (PF, TF, and OF) and eyes closed (PF and TF). The same phenomenon occurred in children with SNHL and associated vestibular dysfunction in all of the positions assessed with eyes open and eyes closed (PF, TF, and OF). CONCLUSION: The larger the degree of SNHL, the greater the balance instability of the children. The children with SNHL and associated vestibular dysfunction showed the highest balance instabilities in this study. IMPACT: Children with larger degrees of SNHL and associated vestibular dysfunction might require prolonged periods to rehabilitate their balance.
Assuntos
Perda Auditiva Neurossensorial/complicações , Transtornos das Habilidades Motoras/complicações , Equilíbrio Postural/fisiologia , Transtornos de Sensação/complicações , Transtornos de Sensação/etiologia , Doenças Vestibulares/complicações , Vestíbulo do Labirinto/patologia , Estudos de Casos e Controles , Criança , Estudos Transversais , Eletronistagmografia , Feminino , Perda Auditiva/complicações , Perda Auditiva Neurossensorial/terapia , Humanos , Masculino , Transtornos de Sensação/diagnóstico , Transtornos de Sensação/fisiopatologia , Doenças Vestibulares/diagnóstico , Testes de Função VestibularRESUMO
AIM: This research aims to analyze the acute effect of incremental inspiratory loads on respiratory pattern and on the predominant activity frequency of inspiratory muscle, taking into account differences in gender responses. Optoelectronic Plethysmography was performed during loads in 39 healthy subjects (20 women), placing 89 markers on the thoracic-abdominal wall to obtain total and regional volumes. Surface electromyography (SEMG) was taken simultaneously on the Sternocleidomastoid and Diaphragm muscles, to calculate the predominant muscle activity frequency through wavelet analysis. Inspiratory loads were performed using Threshold(®)with 2 min of breathing at different levels, ranging from a load of 10 cmH(2)O plus 5 cmH(2)O to 40 cmH(2)O or fatigue. RESULTS: Inspiratory Time increased during loads. Total and compartmental volumes increased with different regions, changing at different loads. These changes in volume occur earlier in women (20 cmH(2)O) than in men (30 cmH(2)O). The predominant activity frequency of Sternocleidmastoid muscle decreased at 30 cmH(2)O, while Diaphragm activity decreased at 40 cmH(2)O. CONCLUSION: The acute effects of incremental inspiratory loads are increases of total and regional volumes and inspiratory time. As for muscle activity, the predominant activity frequency declined in Sternocleidomastoid and Diaphragm muscles, but at different loads. Such respiratory and SEMG patterns and gender differences should be considered when clinical interventions are performed.
Assuntos
Eletromiografia , Inalação/fisiologia , Músculos Respiratórios/fisiologia , Parede Torácica/fisiologia , Músculos Abdominais , Adolescente , Adulto , Antropometria , Estudos Transversais , Diafragma/fisiologia , Feminino , Voluntários Saudáveis , Humanos , Masculino , Músculo Esquelético , Tamanho do Órgão , Pletismografia , Caracteres Sexuais , Suporte de Carga/fisiologia , Adulto JovemRESUMO
The quick-release technique to estimate musculotendinous (MT) stiffness has been extensively used over the last years, in both animals and humans, to gain insights in the adaptive process of the series elastic component (SEC). Recently, MT stiffness quantification, i.e., SEC behavior, has been revisited for subjects not able to fully activate their muscles (effects of long-term spaceflight or non-mature muscles). Such a phenomenon can also be encountered in stunted children. So, the aim of the present study was to analyze the effect of stunting on MT stiffness taking into account possible defect in muscle activation. For this study, 20 eutrophic children (EU) with an average age of 9years±4months were compared to 11age matched stunted children (S) evaluated by the height-to-age index. The MT stiffness index was obtained with regard to stiffness-torque and stiffness-soleus EMG relationships. The children of the S group presented a significantly lower Maximal Voluntary Contraction (MVC) in plantar flexion in comparison with children of the EU group (-37.8%). The significantly lower MT stiffness index for S children (-42.6%) was evidenced only when quantified with regard to the stiffness-soleus EMG relationship (66.5±42.8 vs. 38.2±19.9 Nmrad(-1)%(-1)). Possible delay in fiber type differentiation or tendinous structure maturation can account for the lower MT stiffness index in S children. In conclusion, stunting during early childhood delays the differentiation and maturation processes of musculotendinous structures as shown by the lower MT stiffness quantified with regards to muscle activity, also altered for stunted prepubertal children.
Assuntos
Eletromiografia/métodos , Transtornos do Crescimento/fisiopatologia , Desnutrição/fisiopatologia , Contração Muscular , Músculo Esquelético/fisiopatologia , Resistência Física , Tendões/fisiopatologia , Criança , Módulo de Elasticidade , Feminino , Transtornos do Crescimento/etiologia , Humanos , Masculino , Desnutrição/complicações , Reprodutibilidade dos Testes , Sensibilidade e EspecificidadeRESUMO
The influence of overweight, as a precursor to obesity, was analyzed on the elastic properties of the triceps surae. Based on body mass index (BMI), children (9 years ± 4 mo) were classified as control (CON; n = 23; BMI -1SD>Z score<1SD) or overweight (OW; n = 21, BMI 1SD>Z score<3SD) with regard to reference data from the World Health Organization. Musculotendinous (MT) stiffness of the series elastic component (SEC) was determined using quick-release tests to obtain 1) the MT stiffness index from the slope of either linear stiffness-torque (SI(MT-Torque)) or stiffness-EMG (SI(MT-EMG)) relationships and 2) passive stiffness from the intercept point with the ordinate. Finally, the SEC active (α(0)) and passive fractions (C(passive)) were separated as described by Morgan (Am J Physiol, 1977), using alpha-torque (α(0-Torque,) C(passive-Torque)) or alpha-EMG (α(0-EMG,) C(passive-EMG)) relationships. No significant differences in SI(MT-Torque) or α(0-Torque) were observed between OW and CON. SI(MT-EMG) or α(0-EMG) values were significantly different between OW and CON, which indicate an increase in MT stiffness. In all cases, passive stiffness (K(p), C(passive-torque), C(passive-EMG)) was significantly greater in OW but independent of the activation capacities. These results indicate that a weight-related additional loading of the MT structures in OW children caused the MT system to response accordingly to the functional demand, i.e., higher stiffness of the MT structures due to a concomitant increase in the stiffness of the SEC passive and active fraction. This study also reveals that possible differences in the activation capacities influence the determination of MT stiffness of the SEC active fraction.
Assuntos
Articulação do Tornozelo/fisiologia , Elasticidade/fisiologia , Contração Muscular/fisiologia , Músculo Esquelético/fisiologia , Sobrepeso/fisiopatologia , Antropometria/métodos , Índice de Massa Corporal , Criança , Feminino , Humanos , Masculino , Fenômenos Fisiológicos Musculoesqueléticos , TorqueRESUMO
Malnutrition can lead to possible irreversible consequences in the development of muscle function and some of them are yet poorly characterized. The present study evaluated the mechanical properties of the triceps surae and motor performance in stunted (S) and eutrophic (E) prepubertal children (9 years ± 6 months). Height-for-age ratio was used as indicator of stunting due to early malnutrition, according to the World Health Organization. Torque was determined by maximal voluntary contractions (MVC) and musculotendinous (MT) stiffness was achieved through quick-release tests to obtain MT stiffness index (SI(MT)) and passive stiffness (K (p)) from linear MT stiffness-torque relationships. Percutaneous supramaximal electrically elicited contractions determined twitch torque (Pt) and electromechanical delay (EMD). Motor performance was evaluated by balance test. S group presented significantly lower MVC and a trend of lower Pt values indicating lower capacities to develop force under voluntary or induced conditions. Significantly higher SI(MT) and EMD values were observed, while K (p) and motor performance in balance were significantly lower. Higher SI(MT) values have been reported previously in youngest prepubertal children, indicating that immature activation capacities can mask MT stiffness assessment during voluntary contractions, taking into consideration the higher EMD values as a measure of muscle stiffness contribution. Lower K (p) may indicate a delay in the maturation of tendinous tissue in S group, influencing motor performance in balance. The present study shows that malnutrition leads to adaptation of intrinsic MT elastic properties, but depends on the level of the observed structure.
Assuntos
Transtornos do Crescimento/fisiopatologia , Desnutrição/fisiopatologia , Atividade Motora/fisiologia , Músculo Esquelético/fisiopatologia , Fenômenos Biomecânicos , Estatura/fisiologia , Criança , Elasticidade , Feminino , Transtornos do Crescimento/etiologia , Humanos , Perna (Membro)/fisiologia , Masculino , Desnutrição/complicações , Movimento/fisiologia , Contração Muscular/fisiologia , Músculo Esquelético/crescimento & desenvolvimento , Equilíbrio Postural , TorqueRESUMO
The use of biomechanical methods to quantify functional/physiological parameters in malnourished humans can provide new insights into the understanding of effects of malnutrition on human muscles. Therefore, a transportable ankle ergometer device was developed, which allows the quantification of mechanical properties of the human plantarflexor muscles in field experiments. More precisely, the ergometer quantifies isometric force in static conditions and musculotendinous stiffness in dynamic conditions. This latter parameter is obtained by the quick-release technique. The aim of the study was first to conduct a reproducibility study on musculotendinous stiffness. Seven healthy subjects were tested three times in alternate days. The results showed the well-known linear relationship between musculotendinous stiffness and torque, where the slope was used as a stiffness index (SI(MT)). Individual regression line comparison indicated that SI(MT) values were not significantly different between the three repeated measurements (P>0.05). Mean coefficient of variation was 4.5+/-1.0%. The individual SI(MT) data were within the range of those reported in the literature. The reproducibility study showed that the quantification of musculotendinous stiffness by means of the quick-release technique is a reliable method, using a transportable ankle ergometer device.