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Agradecemos a compreensão. on 2017-08-29T18:10:22Z (GMT) / Submitted by DEBORAH HEBLING SPINOSO null (deborahebling@yahoo.com.br) on 2017-08-29T20:49:31Z No. of bitstreams: 1 tese_deborah_hebling_final.pdf: 3147283 bytes, checksum: ac2d7fc2bcd93ba20297af7c177b8802 (MD5) / Approved for entry into archive by Luiz Galeffi (luizgaleffi@gmail.com) on 2017-08-29T20:58:54Z (GMT) No. of bitstreams: 1 spinoso_dh_dr_rcla.pdf: 3147283 bytes, checksum: ac2d7fc2bcd93ba20297af7c177b8802 (MD5) / Made available in DSpace on 2017-08-29T20:58:54Z (GMT). No. of bitstreams: 1 spinoso_dh_dr_rcla.pdf: 3147283 bytes, checksum: ac2d7fc2bcd93ba20297af7c177b8802 (MD5) Previous issue date: 2017-08-04 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / Introdução: A osteoartrite é a doença reumática mais prevalente na população, caracterizada por degeneração progressiva da cartilagem articular que resulta em incapacidade funcional. O joelho é a articulação mais comumente afetada, sendo uma das condições clínicas mais incapacitantes da doença. A osteoartrite de joelho (OAJ) não tem cura e a limitação da mobilidade causada pela doença muitas vezes não condiz com os exames de imagem usados como critério de classificação de severidade. O comprometimento do desempenho biomecânico é a principal repercussão da OAJ. Assim, a identificação de variáveis biomecânicas que discriminem indivíduos acometidos pela doença e que são determinantes para garantir o bom desempenho funcional pode contribuir para o diagnóstico mais preciso e auxiliar no direcionamento do tratamento desses pacientes afim de retardar ou prevenir incapacidades. Objetivos: identificar a variável biomecânica que discrimine mulheres com OAJ daquelas na mesma faixa etária sem a doença e estabelecer valores de corte para essas variáveis. O segundo objetivo foi identificar a variável preditora de funcionalidade após dez meses de acompanhamento e propor limiares que indiquem declínio físico-funcional nessa população. Métodos: Participaram do estudo mulheres com idade entre 50-75 anos, com osteoartrite de joelho e mulheres saudáveis, sem histórico de alterações relacionadas a doenças crônico-degenerativas em membros inferiores. Os procedimentos de avaliação foram realizados em dois dias. No primeiro dia foram realizadas as avaliações da mobilidade funcional, aplicação de questionários para verificação do estado de saúde e familiarização com o teste de força. No segundo dia de coleta foi realizada a avaliação do torque isométrico extensor do joelho e avaliação biomecânica da marcha. As avaliações foram repetidas três vezes o grupo com OAJ por um período de dez meses. Para análise dos dados cinemáticos foram calculados: a velocidade, tempo de apoio, tempo de balanço, tempo de passada e tempo de duplo apoio. Os dados eletromiográficos analisados foram: tempo motor, tempo pré-motor, tempo de reação e a co-contração antagonista. Além disso, foi avaliado torque muscular dos extensores de joelho e a taxa de desenvolvimento de torque (TDT). Posteriormente, para análise estatística foi aplicado o teste MANOVA para comparação entre os grupos e ANOVA Medidas Repetidas para comparação das avaliações no grupo OAJ. Para determinação das variáveis preditoras foi feita a Análise da Função Discriminante Step Wise e Área da Curva ROC. Resultados: Mulheres com OAJ apresentaram comprometimento funcional para todas as variáveis analisadas (p<0,05). Para discriminação entre os grupos, foi encontrado que o torque extensor de joelho, TDT inicial e tardia, velocidade da marcha e pontuação no teste funcional foram as variáveis que melhor diferenciaram os grupos com limiares de 1,2 Nm Kg-1, 2,06 Nm.s-1 Kg-1, 1,72 Nm.s -1 Kg-1, 1,07 ms e 9,8, respectivamente. Em relação a limitação funcional ao longo dos onze meses de acompanhamento foi encontrado que a TDT e tempo de apoio são as variáveis biomecânicas que melhor predizem o desempenho funcional, sendo o valor de corte dessas variáveis 1,42 Nm.s-1 Kg-1 e 0,58 segundos, respectivamente. Conclusão: Mulheres com OAJ apresentam comprometimento da mobilidade funcional ao longo do período de onze meses. A TDT é a variável que pode discriminar o grupo em relação a indivíduos da mesma idade sem a doença e predizer o nível de funcionalidade, assim como o tempo de apoio da marcha. Além disso, velocidade de marcha e testes funcionais podem auxiliar a discriminar mulheres acometidas pela doença. / Introduction: Osteoarthritis is the most prevalent rheumatic disease in the population, characterized by progressive degeneration of the articular cartilage resulting in functional disability. The knee (OAJ) is the joint most commonly affected, being one of the most disabling clinical conditions of the disease. The OAJ has no cure and the functional limitation caused by the disease often does not match the imaging tests used as a criterion of severity classification. The impairment of functional performance is the main repercussion of OAJ. Therefore, the identification of biomechanical variables that discriminate individuals affected by the disease and that are determinant to guarantee the good functional performance can contribute to a more precise diagnosis and help in directing the treatment of these patients in order to delay or prevent disabilities. Objective: to identify the biomechanical variable that discriminates women with OAJ from those in the same age group without the disease and to establish cutoff values for these variables. The second objective was to identify the functional predictor variable after ten months of follow-up and propose thresholds that indicate physical-functional decline in this population. Methods: The study included women aged 50-75 years with osteoarthritis of the knee and healthy women with no history of changes related to chronic degenerative diseases in the lower limbs. The evaluation procedures were carried out in two days. On the first day, functional mobility assessments were carried out, questionnaires were applied to verify the health status and familiarization with the strength test. On the second day of collection, knee extensor isometric torque was evaluated and gait biomechanical evaluation. The evaluations were repeated three time for the OAJ group for a period of ten months. To analyze the data were calculated: for kinematic data, velocity, support time, swing time, run time and double support time; For electromyographic data, motor time, pre-motor time, reaction time and antagonistic co-contraction. In addition, muscle torque of knee extensors and torque development rate (TDT) were evaluated. Subsequently, for the statistical analysis, the MANOVA test was used for comparison between the groups and ANOVA Repeated Measures for comparison of the evaluations in the OAJ group. Discriminant Function Analysis Step Wise and ROC Curve Area were used to determine the predictive variables. Results: Women with OAJ presented functional impairment for all variables analyzed (p <0.05). For discrimination between groups, it was found that knee extensor torque, initial and late TDT, gait velocity and functional test scores were the variables that best differentiated the groups with thresholds of 1.2 Nm kg -1, 2.06 Nm.s-1 Kg -1, 1.72 Nm.s -1 Kg -1, 1.07 ms, and 9.8, respectively. Regarding the functional limitation during the eleven months of follow-up, it was found that DTT and support time are the biomechanical variables that best predict functional performance, being the cutoff value of these variables 1.42 Nm.s-1 Kg-1 And 0.58 seconds, respectively. Conclusion: Women with OAJ present impaired functional mobility over the eleven-month period. DTT is the variable that can discriminate the group in relation to individuals of the same age without the disease and predict the level of functionality, as well as the gait support time. In addition, walking speed and functional tests may help to discriminate against women affected by the disease.

Introdução: Estudos recentes têm mostrado que as quedas são a causa externa de morte mais importante entre idosos, podendo levar a hospitalização, lesões, dependência e aumento nos custos dos serviços sociais e de saúde. O comprometimento da mobilidade funcional é um importante fator de risco para quedas, mas aspectos sociais, ambientais e comportamentais também podem influenciar nesse evento. Objetivo: Identificar os aspectos socioeconômicos e contextuais associados com a mobilidade funcional e quedas em idosos residentes no município de São Paulo. Métodos: Foram utilizados os dados do Estudo Saúde, Bem-Estar e Envelhecimento (SABE), uma amostra representativa para os indivíduos com idade igual ou superior a 60 anos do município de São Paulo, em 2010. As variáveis dependentes do estudo foram a ocorrência de alguma queda no último ano e o comprometimento da mobilidade funcional, mensurada pelo teste Timed Up and Go (TUG). Fatores individuais (estado marital, raça/cor, anos de estudo e percepção de suficiência de renda) e contextuais (Índice de Gini, área verde/ habitante, taxa de homicídio e percentual de domicílios em favelas) foram analisados por modelos logísticos multiníveis. Resultados: De 1.190 idosos inclusos, 29 por cento relataram ter caído no último ano e 46 por cento apresentaram comprometimento da mobilidade funcional. Os fatores individuais socioeconômicos não apresentaram associação com a ocorrência de queda, mas ter 8 anos ou mais de anos de estudo foi um fator protetor para comprometimento da mobilidade em todos os modelos testados (OR: 0,56). Morar em subprefeituras com taxa de homicídio moderada apresentou associação com chance aumentada de cair (OR: 1.51, 95 por cento IC: 1.09-2.07). Moderada área verde se associou com maior chance de cair entre os indivíduos com 80 anos e mais (OR:2,63, 95 por cento IC: 1.23-5.60). Conclusão: Os resultados estão de acordo com a literatura em relação à associação das características do bairro de residência com quedas e mobilidade funcional em idosos. Estratégias voltadas para prevenção de quedas e de dificuldade na mobilidade funcional devem considerar aspectos sociais e ambientais de locais públicos. Este estudo foi financiado pela Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) (nº processo: 2014/06721-4) / Introduction: Recent studies show that falls are the most important external cause of death in elders, leading to hospitalization, injuries, dependency, and to increased costs of health and social care services. Functional mobility impairment is a risk factor for falling, but social, environmental and behavioral aspects may also affect this event. Objective: To identify the socioeconomics and contextual aspects associated with functional mobility and falls in elderly residents of the Municipality of São Paulo, Brazil. Methods: We used data from Health, Wellbeing and Aging (SABE) Study, a representative study of individuals aged 60 and older of the Municipality of São Paulo in 2010. The dependent variables of interest were the occurrence of any fall in the last year and functional mobility impairment, assessed by the Timed Up and Go (TUG) test. Individual (marital status, race, years of schooling and perception of income sufficiency) and contextual (Gini coefficient, green areas per capita, and homicide rate) factors were analyzed by multilevel logistic models. Results: From the sample of 1,190 elderly individuals, 29 per cent reported a fall in the last year and 46 per cent had mobility impairment. The socioeconomic individual factors were not significantly associated with falling, but having eight or more years of schooling was a protective factor for mobility impairment for every model (OR: 0.56). Living in a neighborhood with a moderate homicide rate was associated with higher odds of falling (OR: 1.51, 95 per cent CI: 1.09-2.07). Neighborhoods with moderate greens spaces were associated with higher odds of falling for individuals 80 years old and older (OR: 2.63, 95 per cent CI: 1.23-5.60). Conclusion: Our findings support the concern that neighborhood characteristics are associated with falls and mobility impairment for the elderly. Strategies to prevent falls and mobility impairment in developing countries should consider public environment and social aspects.

Introdução: Estudos recentes têm mostrado que as quedas são a causa externa de morte mais importante entre idosos, podendo levar a hospitalização, lesões, dependência e aumento nos custos dos serviços sociais e de saúde. O comprometimento da mobilidade funcional é um importante fator de risco para quedas, mas aspectos sociais, ambientais e comportamentais também podem influenciar nesse evento. Objetivo: Identificar os aspectos socioeconômicos e contextuais associados com a mobilidade funcional e quedas em idosos residentes no município de São Paulo. Métodos: Foram utilizados os dados do Estudo Saúde, Bem-Estar e Envelhecimento (SABE), uma amostra representativa para os indivíduos com idade igual ou superior a 60 anos do município de São Paulo, em 2010. As variáveis dependentes do estudo foram a ocorrência de alguma queda no último ano e o comprometimento da mobilidade funcional, mensurada pelo teste Timed Up and Go (TUG). Fatores individuais (estado marital, raça/cor, anos de estudo e percepção de suficiência de renda) e contextuais (Índice de Gini, área verde/ habitante, taxa de homicídio e percentual de domicílios em favelas) foram analisados por modelos logísticos multiníveis. Resultados: De 1.190 idosos inclusos, 29 por cento relataram ter caído no último ano e 46 por cento apresentaram comprometimento da mobilidade funcional. Os fatores individuais socioeconômicos não apresentaram associação com a ocorrência de queda, mas ter 8 anos ou mais de anos de estudo foi um fator protetor para comprometimento da mobilidade em todos os modelos testados (OR: 0,56). Morar em subprefeituras com taxa de homicídio moderada apresentou associação com chance aumentada de cair (OR: 1.51, 95 por cento IC: 1.09-2.07). Moderada área verde se associou com maior chance de cair entre os indivíduos com 80 anos e mais (OR:2,63, 95 por cento IC: 1.23-5.60). Conclusão: Os resultados estão de acordo com a literatura em relação à associação das características do bairro de residência com quedas e mobilidade funcional em idosos. Estratégias voltadas para prevenção de quedas e de dificuldade na mobilidade funcional devem considerar aspectos sociais e ambientais de locais públicos. Este estudo foi financiado pela Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) (nº processo: 2014/06721-4) / Introduction: Recent studies show that falls are the most important external cause of death in elders, leading to hospitalization, injuries, dependency, and to increased costs of health and social care services. Functional mobility impairment is a risk factor for falling, but social, environmental and behavioral aspects may also affect this event. Objective: To identify the socioeconomics and contextual aspects associated with functional mobility and falls in elderly residents of the Municipality of São Paulo, Brazil. Methods: We used data from Health, Wellbeing and Aging (SABE) Study, a representative study of individuals aged 60 and older of the Municipality of São Paulo in 2010. The dependent variables of interest were the occurrence of any fall in the last year and functional mobility impairment, assessed by the Timed Up and Go (TUG) test. Individual (marital status, race, years of schooling and perception of income sufficiency) and contextual (Gini coefficient, green areas per capita, and homicide rate) factors were analyzed by multilevel logistic models. Results: From the sample of 1,190 elderly individuals, 29 per cent reported a fall in the last year and 46 per cent had mobility impairment. The socioeconomic individual factors were not significantly associated with falling, but having eight or more years of schooling was a protective factor for mobility impairment for every model (OR: 0.56). Living in a neighborhood with a moderate homicide rate was associated with higher odds of falling (OR: 1.51, 95 per cent CI: 1.09-2.07). Neighborhoods with moderate greens spaces were associated with higher odds of falling for individuals 80 years old and older (OR: 2.63, 95 per cent CI: 1.23-5.60). Conclusion: Our findings support the concern that neighborhood characteristics are associated with falls and mobility impairment for the elderly. Strategies to prevent falls and mobility impairment in developing countries should consider public environment and social aspects.

It is well established that aging is associated with numerous health concerns, including poor balance. Deteriorations in attention demand also place older adults at a greater risk for falls. Emerging experiments have explored the impact of dual-task training programs and have improved dual-tasking in older adults. However, it is unknown whether these performance-related improvements are a function of the intervention itself or the repeated exposure to the testing protocol. Study 1 explored the implications of repeated administration, once per week for 5 weeks, of a protocol involving standing postural sway while concurrently performing reaction time (RT) tasks in older adults. Results revealed that postural sway was stable across testing sessions whereas the difficult RT task gradually improved over time. Study 2 examined the influence of repeated exposure, once per week for 5 weeks, of a protocol involving negotiating a series of obstacles while performing RT tasks in older adults. Participants walked significantly faster with repeated exposure and gradually improved RT. Study 3 investigated the impact of repeated exposure, once per week for 5 weeks, to three functional mobility measures in older adults. It also examined the influence of a 12-week balance and mobility training (BMT) program as well as a 12-week balance and mobility plus cognitive training (BMT+C) program on functional mobility in older adults. Functional mobility served to be stable over time. Both the BMT and BMT+C groups significantly improved functional mobility and sustained these improvements at the 12-week follow-up, while no changes were observed in the control group. No differences between the BMT and BMT+C groups emerged. Experiment 4 examined the influence of BMT and BMT+C on postural sway and RT in older adults. Participants in both training groups significantly improved RT and sustained these improvements at the follow-up, while no changes were observed in the control group. No changes to postural control were shown in any group. No differences between the BMT and BMT+C groups emerged. Experiment 5 examined the influence of BMT and BMT+C on negotiating a series of obstacles while performing RT tasks in older adults. Both the BMT and BMT+C groups significantly improved RT and sustained these improvements at the follow-up, while no changes were observed in the control group. All groups showed faster time to completion of the obstacle series. No differences between the BMT and BMT+C groups emerged. Collectively, these findings suggest that BMT and BMT+C significantly improve functional mobility and divided attention, and sustain these improvements over time. Although some improvements were observed after repeated exposure over 5 weeks, no changes in the control group were observed. Therefore, the improvements exhibited from BMT and BMT+C are likely not a function of repeated exposure to the testing protocol, as participants may be more susceptible to performance-related improvements when the testing sessions are close in proximity. Altogether, these findings propose that, whether or not cognitive training is included, attention demanding dual-task training not only improves functional mobility and RT, but also sustains these improvements over time in older adults. These results may be used to improve the prescription of exercise in older adults.

Introduction: Cerebral palsy (CP) is a CNS related permanent disorder following a lesion on the developing brain. Spasticity and muscle weakness are the most commonly reported impairments. Aim: To describe spasticity measured instrumentally as the muscle resistance and muscle strength in children with CP and in typically developing children (TD), and explore the relationship between muscle resistance, muscle strength and functional mobility. Method: Measurements of the muscle resistance in plantarflexors with Neuroflexor®. Muscle strength measurements in the lower leg with a rig-fixed dynamometry in n= 4 children with CP and in n = 11 TD children. Timed Up and Go (TUG) test measured in seconds in 4 children with CP. Results: Mann- Whitney U test showed a significant increased muscle resistance in plantarflexors during a fast movement between children with CP and TD children (p = 0.044). It was significantly shown that the children with CP were weaker in their dorsiflexors compared to the group of TD children (p = 0,001). Analysis for muscle resistance and TUG was collected for 2 children with CP and therefore no correlation analysis could be made. Conclusion: This pilot study indicates that the children with CP were weaker in their dorsiflexors compared to TD children and that muscle resistance measured during a passive elongation was higher, but no statistically significant conclusion can be made due to few included numbers of participants.

No description available.

As is known to all, the aging problem becomes more and more serious in recent years. The issues “get into and out of a chair”, from one of the self-care tasks of aging people named Functional mobility in ADLs (Activity of daily livings), need to be solved carefully in efficient ways to help seniors and patients who have physical problems dealing with their daily life. In this previous investigation, the existing products in the market are normally quite heavy and importable. After combined with the advantages of the existing products and some improvements in portability and comfort which is related to human engineering. A Pneumatic Cushion for Supporting Standing and Sitting Process, based on airbag and pneumatic system which has been designed in this thesis, can be used by user who has physical-trouble for standing up and sitting down. Meanwhile, after being assembled with some specific extra components, it can be used as a mobility aid device. For the whole designing process, many relevant article, video sources and websites are referred for the previous researches, including Google Scholar, BTH Digital Library and YouTube. The product was designed and analysed in Inventor 2018 and the fluid dynamic simulation has been done in Abaqus. Studies involved lifting function are selected after the survey about assist appliance and aid appliance market.

Made available in DSpace on 2014-06-11T19:22:50Z (GMT). No. of bitstreams: 0 Previous issue date: 2009-02-11Bitstream added on 2014-06-13T20:49:23Z : No. of bitstreams: 1 kleiner_afr_me_rcla.pdf: 566600 bytes, checksum: d8253edc28bf74475de96a7dc97bc3c0 (MD5) / Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) / De acordo com a Classificação Internacional de Funcionalidade, Incapacidade e Saúde (CIF), o controle do movimento na funcionalidade é influenciado pelas especificidades da condição da saúde, das deficiências neuromusculoesqueléticas e do contexto onde o indivíduo atua. Com base na CIF, o objetivo geral desta dissertação foi investigar a mobilidade funcional (MF) de indivíduos PCE, por meio de dois estudos: Estudo 1, exploratório comparando a MF em superfícies diferentes (regular e irregular); e o Estudo 2, análise quantitativa da locomoção sobre obstáculos com diferentes alturas. O Estudo 1 comparou a MF de indivíduos com PCE nas distâncias: 5m, 50m e 500m. O ambiente regular apresentava o relevo liso, livre de obstáculos, como corredores e quadras poliesportivas. O ambiente irregular era caracterizado por locais pertencentes ao cotidiano do avaliado, como sua residência, escola e vizinhança. Participaram deste estudo 31 indivíduos, de 5 a 16 anos com PCE, distribuídos em dois grupos etários (crianças=5 a 11 anos e adolescentes=12 a 16 anos) e pelo tipo de PCE (bilateral=diplégicos e tetraplégicos; e unilateral=hemiplégicos). Foram avaliados a MF pela Escala de MF (EMF) e o tempo gasto. Os resultados apontaram que: 1) o ambiente influencia na MF de indivíduos PCE (5m e 500m); 2) não foram encontradas diferenças entre os tipos de PCE para as classificações da EMF e tempo gasto em nenhum tipo de ambiente; e, 3) as características estruturais do indivíduo PCE, inferidos pelo grupo etário, influenciam no tempo gasto (5m e os 500m). O Estudo 2 teve como objetivo quantificar as estratégias locomotoras adaptativas de crianças PCE na tarefa de transpor obstáculos com diferentes alturas e compará-las quanto ao tipo de PCE (diplégica X hemiplégica) e hemicorpo. Participaram deste estudo 12 crianças, entre 7 e 12 anos de idade, sendo 6 com PCE diplégica... / According to the International Classification of Functioning, Disability and Health (ICF), movement control in functionality is affected by the specificities of health condition, the neuromusculoskeletal deficits, and the context that the individuals act. Based on CIF, the main objective of this dissertation was to investigate the functional mobility (FM) in SCP individuals, through two studies: Study 1, an exploratory study that compared the FM between different environments (regular and irregular), and Study 2, a quantitative analysis of locomotion over obstacles with different heights. The Study 1 compared the FM of SCP individuals in three distances: 5m, 50m and 500m. The regular environment showed a even surface, free from obstacles, such as corridors or gymnasium. The irregular environment was characterized by the subjects’ day-byday places, such as their residence, school and neighborhood. The study included 31 individuals, from 5 to 16 years old with SCP, distributed into two age groups (children = 5 to 11 years old, and adolescents = 12 to 16 years old) and the SCP type (bilateral = diplegic and quadriplegic, and unilateral = hemiplegic). We evaluated the FM by means of the FM Scale (FMS) and the time spent. The results showed: 1) the environment influences the SCP individuals FM (5m and 500m); 2) differences between SCP type were not found in FMS classifications and in time spent for any type of environment; and 3) the structural features of the individuals PCE, inferred by age group, influenced the time spent (5m and 500m). The Study 2 aimed to quantify the adaptive locomotion strategies of SCP children during the obstacle crossing with different heights, and to compare it according to SCP type and hemibody. The study included 12 children, between 7 and 12 years of age, 6 diplegic SCP and 6 hemiplegic SCP. Passive reflective markers were fixed bilaterally on the lateral... (Complete abstract click electronic access below)

Orientador: Lilian Teresa Bucken Gobbi / Banca: Marisa Cotta Mancini / Banca: Ricardo Machado Leite de Barros / Resumo: De acordo com a Classificação Internacional de Funcionalidade, Incapacidade e Saúde (CIF), o controle do movimento na funcionalidade é influenciado pelas especificidades da condição da saúde, das deficiências neuromusculoesqueléticas e do contexto onde o indivíduo atua. Com base na CIF, o objetivo geral desta dissertação foi investigar a mobilidade funcional (MF) de indivíduos PCE, por meio de dois estudos: Estudo 1, exploratório comparando a MF em superfícies diferentes (regular e irregular); e o Estudo 2, análise quantitativa da locomoção sobre obstáculos com diferentes alturas. O Estudo 1 comparou a MF de indivíduos com PCE nas distâncias: 5m, 50m e 500m. O ambiente regular apresentava o relevo liso, livre de obstáculos, como corredores e quadras poliesportivas. O ambiente irregular era caracterizado por locais pertencentes ao cotidiano do avaliado, como sua residência, escola e vizinhança. Participaram deste estudo 31 indivíduos, de 5 a 16 anos com PCE, distribuídos em dois grupos etários (crianças=5 a 11 anos e adolescentes=12 a 16 anos) e pelo tipo de PCE (bilateral=diplégicos e tetraplégicos; e unilateral=hemiplégicos). Foram avaliados a MF pela Escala de MF (EMF) e o tempo gasto. Os resultados apontaram que: 1) o ambiente influencia na MF de indivíduos PCE (5m e 500m); 2) não foram encontradas diferenças entre os tipos de PCE para as classificações da EMF e tempo gasto em nenhum tipo de ambiente; e, 3) as características estruturais do indivíduo PCE, inferidos pelo grupo etário, influenciam no tempo gasto (5m e os 500m). O Estudo 2 teve como objetivo quantificar as estratégias locomotoras adaptativas de crianças PCE na tarefa de transpor obstáculos com diferentes alturas e compará-las quanto ao tipo de PCE (diplégica X hemiplégica) e hemicorpo. Participaram deste estudo 12 crianças, entre 7 e 12 anos de idade, sendo 6 com PCE diplégica... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: According to the International Classification of Functioning, Disability and Health (ICF), movement control in functionality is affected by the specificities of health condition, the neuromusculoskeletal deficits, and the context that the individuals act. Based on CIF, the main objective of this dissertation was to investigate the functional mobility (FM) in SCP individuals, through two studies: Study 1, an exploratory study that compared the FM between different environments (regular and irregular), and Study 2, a quantitative analysis of locomotion over obstacles with different heights. The Study 1 compared the FM of SCP individuals in three distances: 5m, 50m and 500m. The regular environment showed a even surface, free from obstacles, such as corridors or gymnasium. The irregular environment was characterized by the subjects' day-byday places, such as their residence, school and neighborhood. The study included 31 individuals, from 5 to 16 years old with SCP, distributed into two age groups (children = 5 to 11 years old, and adolescents = 12 to 16 years old) and the SCP type (bilateral = diplegic and quadriplegic, and unilateral = hemiplegic). We evaluated the FM by means of the FM Scale (FMS) and the time spent. The results showed: 1) the environment influences the SCP individuals FM (5m and 500m); 2) differences between SCP type were not found in FMS classifications and in time spent for any type of environment; and 3) the structural features of the individuals PCE, inferred by age group, influenced the time spent (5m and 500m). The Study 2 aimed to quantify the adaptive locomotion strategies of SCP children during the obstacle crossing with different heights, and to compare it according to SCP type and hemibody. The study included 12 children, between 7 and 12 years of age, 6 diplegic SCP and 6 hemiplegic SCP. Passive reflective markers were fixed bilaterally on the lateral... (Complete abstract click electronic access below) / Mestre

Submitted by Aelson Maciera (aelsoncm@terra.com.br) on 2017-08-29T18:19:24Z No. of bitstreams: 1 DissLCBC.pdf: 4202058 bytes, checksum: 7cbca73387e14969ba519cbe35c38780 (MD5) / Approved for entry into archive by Ronildo Prado (producaointelectual.bco@ufscar.br) on 2017-11-09T17:47:10Z (GMT) No. of bitstreams: 1 DissLCBC.pdf: 4202058 bytes, checksum: 7cbca73387e14969ba519cbe35c38780 (MD5) / Approved for entry into archive by Ronildo Prado (producaointelectual.bco@ufscar.br) on 2017-11-09T17:47:20Z (GMT) No. of bitstreams: 1 DissLCBC.pdf: 4202058 bytes, checksum: 7cbca73387e14969ba519cbe35c38780 (MD5) / Made available in DSpace on 2017-11-09T17:55:04Z (GMT). No. of bitstreams: 1 DissLCBC.pdf: 4202058 bytes, checksum: 7cbca73387e14969ba519cbe35c38780 (MD5) Previous issue date: 2017-02-20 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / Introduction: The Wheelchair Skills Test Questionnaire is a tool that measures the functional mobility in different environments and that can contribute to improving the skills of people in wheelchairs reflecting on trust, safety and independence. In Brazil, there is a gap of assessment, encompassing the use of assistive technology and functional mobility at the level of the necessary skills in the daily lives of people who use wheelchairs and caregivers. Objective: Cross-cultural adaptation of Wheelchair Skills Test Questionnaire (WST-Q), version 4.3 for manual wheelchair users and caregivers, to Portuguese language (Brazil). Methodology: The methodological procedure involved the steps of: 1) translation; 2) back translation; 3) analysis by a committee of experts; 4) pretest according to international guidelines. Results: The version was assessment by 15 wheelchair users and 15 caregivers. In total 8 out of 30 participants presented suggestions to facilitate an understanding of the target audience. The instrument is displayed for easy understanding. Conclusion: The participants approved the WST-Q 4.3 as useful in the Brazilian reality. It is recommended to evaluate the measurement properties for a version in a representative sample. / Introdução: O Wheelchair Skills Test Questionnaire é uma ferramenta que avalia a mobilidade funcional em diferentes ambientes e que pode contribuir para melhorar as habilidades de pessoas em cadeira de rodas repercutindo na confiança, segurança e independência. No Brasil, existe uma lacuna de ferramentas de avaliação, que articulem o uso da tecnologia assistiva e a mobilidade funcional no nível das capacidades necessárias no cotidiano de pessoas que usam cadeira de rodas e de cuidadores. Objetivo: realizar a adaptação transcultural do instrumento Wheelchair Skills Test Questionnaire (WST-Q), versão 4.3 para usuários de cadeiras de rodas manuais e cuidadores, na língua portuguesa (Brasil). Metodologia: O procedimento metodológico envolveu as etapas de: 1) tradução; 2) retrotradução; 3) Análise por um comitê de especialistas; 4) pré-teste conforme diretrizes internacionais. Resultados: A versão resultante deste processo passou por um pré-teste com a população alvo, 15 usuários de cadeira de rodas e 15 cuidadores. No total 8 de 30 participantes apresentaram sugestões para facilitar a compreensão do público alvo. O instrumento se mostrou de fácil compreensão. Conclusão: Os participantes avaliaram o WST-Q 4.3 como útil à realidade brasileira. Recomenda-se avaliação das propriedades de medidas dessa versão numa amostra representativa.