Este estudo teve como objetivo investigar a influência de diferentes estágios de severidade da neuropatia diabética na velocidade de condução das fibras musculares estimada em quatro músculos do membro inferior durante contrações isométricas, utilizando-se eletromiografia de superfície. Oitenta e cinco adultos foram estudados: 16 indivíduos não diabéticos e 69 diabéticos classificados em quatro estágios de neuropatia definidos por um sistema fuzzy: ausente (n=26), leve (n=21), moderada (n=11) e grave (n=11). As velocidades de condução médias das fibras musculares do tibial anterior, gastrocnêmico medial, vasto lateral e bíceps femoral foram avaliadas utilizando uma matriz linear de eletrodos de superfície e foram comparadas entre os grupos estudados por meio de ANOVAs (p < 0,05). As velocidades de condução diminuíram significativamente no grupo com neuropatia moderada para o vasto lateral em relação aos outros grupos (18 a 21% de decréscimo), e foram menores em todos os grupos com diabetes para o tibial anterior em relação ao grupo controle (15 a 20% de decréscimo). Não só a localização anatômica distal do músculo afetou a velocidade de condução, mas também a proporção do tipo de fibras musculares, uma vez que o tibial anterior, com maior proporção de fibras do tipo I, estava com sua velocidade de condução alterada já no grupo ausente, enquanto o vasto lateral, com maior proporção de fibras do tipo II, estava com sua velocidade de condução alterada em estágios mais tardios da doença. De forma geral, os músculos do membro inferior têm diferentes suscetibilidades aos efeitos do diabetes mellitus e da neuropatia e mostram uma redução da velocidade de condução conforme a neuropatia progride / This study aimed at investigating the influence of different stages of diabetic neuropathy in the muscle fiber conduction velocities estimated in four lower limb mucles during isometric maximal voluntary contraction using surface electromyography. Eighty-five adults were studied: 16 non-diabetic individuals and 69 diabetic patients classified into four neuropathy stages, defined by a fuzzy system: absent (n=26), mild (n=21), moderate (n=11) and severe (n=11). Average muscle fiber conduction velocities of gastrocnemius medialis, tibialis anterior, vastus lateralis and biceps femoris were assessed using linear array electrodes, and the studied groups were compared by ANOVAs (p < 0.05). Conduction velocities were significantly decreased in the moderate neuropathy group for the vastus lateralis compared to other groups (from 18 to 21% decrease), and were decreased in all diabetic groups for the tibialis anterior (from 15 to 20% from control group). Not only the distal anatomical localization of the muscle affects the conduction velocity, but also the proportion of muscle fiber type, where the tibialis anterior, with greater type I fiber proportion, is affected already at the absent group while the vastus lateralis with greater type II fiber proportion is affected in later stages of the disease. Generally, the muscles of the lower limb have different responsiveness to the effects of diabetes mellitus and neuropathy and show a reduction in the conduction velocity as the neuropathy progresses

Avaliou-se os efeitos da utilização de um comando verbal detalhado (CVD) e um simplificado (CVS) sobre a força muscular e a flexibilidade em 31 alunos dos cursos de Fisioterapia e de Terapia Ocupacional. O Grupo A submeteu-se a um programa de alongamento muscular com CVD, e o Grupo B, com CVS. Mensurou-se a força muscular por meio da miometria e avaliou-se a flexibilidade e a postura, associando esta com categorias de encurtamentos musculares pré definidas. Observou-se mudanças no contorno de todas as curvaturas e da cadeia posterior no Grupo A e na curvatura cervical e diminuição do ângulo de flexão do quadril no Grupo B. Não houve significância estatística nas demais variáveis estudadas / The use effects of a comprehensive (CVC) and a simplified verbal command (SVC) in 31 physical Therapy and Occupational Therapy students were evaluated. A Group was submitted to a stretching muscle program with CVC, and B Group, With SVC. The muscle strength was measured by myometry and flexibility and posture were evaluated, associating posture with pre defined muscle shortening categories. Changes were found in every spinal curve outline and posterior muscle chain in A Group and in cervical curve outline and decrease of the hip flexion angle in B Group. There was no statistic significance in the other analyzed variables

Thesis (Ph. D.)--University of Missouri--Columbia, 2002. / Typescript. Vita. Includes bibliographical references (leaves 141-160). Also issued on the Internet.

Avaliou-se os efeitos da utilização de um comando verbal detalhado (CVD) e um simplificado (CVS) sobre a força muscular e a flexibilidade em 31 alunos dos cursos de Fisioterapia e de Terapia Ocupacional. O Grupo A submeteu-se a um programa de alongamento muscular com CVD, e o Grupo B, com CVS. Mensurou-se a força muscular por meio da miometria e avaliou-se a flexibilidade e a postura, associando esta com categorias de encurtamentos musculares pré definidas. Observou-se mudanças no contorno de todas as curvaturas e da cadeia posterior no Grupo A e na curvatura cervical e diminuição do ângulo de flexão do quadril no Grupo B. Não houve significância estatística nas demais variáveis estudadas / The use effects of a comprehensive (CVC) and a simplified verbal command (SVC) in 31 physical Therapy and Occupational Therapy students were evaluated. A Group was submitted to a stretching muscle program with CVC, and B Group, With SVC. The muscle strength was measured by myometry and flexibility and posture were evaluated, associating posture with pre defined muscle shortening categories. Changes were found in every spinal curve outline and posterior muscle chain in A Group and in cervical curve outline and decrease of the hip flexion angle in B Group. There was no statistic significance in the other analyzed variables

Orientadores: Maria Patrícia Traina Chacon Mikahil, Cleiton Augusto Libardi / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Educação Física / Made available in DSpace on 2018-08-22T01:21:18Z (GMT). No. of bitstreams: 1 Nogueira_FelipeRomanoDamas_M.pdf: 943593 bytes, checksum: c667da2717da006967d54b083f202d8b (MD5) Previous issue date: 2013 / Resumo: Esta dissertação é composta de uma introdução e um artigo científico original intitulado "Comparison in responses to maximal eccentric exercise between elbow flexors and knee extensors of older adults" aceito para publicação em revista especializada da área. O exercício excêntrico (EE) máximo resulta em significativo dano muscular principalmente em indivíduos não habituados a este tipo de exercício. A magnitude do dano muscular é menor quando o EE é realizado com os músculos extensores do joelho do que quando realizado com os flexores do cotovelo em jovens, provavelmente graças a um efeito protetor nos membros inferiores conferido por maior exposição dos extensores do joelho às contrações excêntricas das atividades de vida diária. No entanto, ainda não se sabe se este também é o caso para indivíduos idosos. É possível que a diferença de dano muscular entre flexores do cotovelo e extensores do joelho seja menor para idosos, uma vez que atividades diárias possam estar reduzidas ou mesmo devido às alterações neuromusculares com o envelhecimento o que promoveria menor adaptabilidade às atividades de vida diária. Desta forma, o presente estudo testou a hipótese que a suscetibilidade ao dano muscular seria similar entre flexores do cotovelo e extensores do joelho para indivíduos idosos. Oito voluntários idosos (61,6 ± 1,8 anos) realizaram 5 séries de 6 contrações excêntricas máximas à velocidade de 90º·s-1 com os flexores do cotovelo (amplitude de movimento: 80-20º) e extensores do joelho (30-90º) utilizando membros não dominantes em ordem randomizada com duas semanas de pausa entre as sessões. Foram medidos os torques voluntários máximos isométricos e concêntricos, ângulo ótimo, amplitude de movimento, dor muscular analisada por escala analógica visual e atividade de creatina quinase (CK) imediatamente após (exceto a CK), e 24, 48, 72 e 96 horas após o EE. As mudanças normalizadas nas variáveis dependentes após o protocolo foram comparadas entre flexores do cotovelo e extensores do joelho utilizando-se do modelo misto de análise, seguido do teste post-hoc de Tukey, quando apropriado. Os resultados indicaram que somente o torque voluntário máximo isométrico e a amplitude de movimento demonstraram significantes efeitos de grupo (p < 0,05) para a comparação entre flexores do cotovelo e extensores do joelho. Adicionalmente, não foi encontrada interação grupo vs. tempo (p > 0,05) para nenhuma das variáveis dependentes comparando entre flexores do cotovelo e extensores do joelho dos idosos. Estes resultados sugerem que os extensores do joelho de idosos são relativamente tão suscetíveis ao dano muscular quanto os flexores de cotovelo, ou, ao menos, a diferença entre membros é pequena para os idosos / Abstract: This dissertation is composed of an introduction and an original article entitled "Comparison in responses to maximal eccentric exercise between elbow flexors and knee extensors of older adults" accepted to publication on a specialized journal. Unaccustomed eccentric exercise induces significant muscle damage. The magnitude of muscle damage is greater for the elbow flexors (EF) compared to the knee extensors (KE) following eccentric contractions (ECC) for young subjects, probably due to a protective effect of the lower limb muscles conferred by greater exposure of KE to ECC performed in daily activities. However, it is not known if it is also the case for old subjects. It is possible that the difference in muscle damage between EF and KE is smaller for old individuals, since daily activities can be reduced or even due to neuromuscular disorders with aging what could promote lower adaptability to activities of daily living. Therefore, the present study compared between elbow flexors (EF) and knee extensors (KE) for their susceptibility to eccentric exercise-induced muscle damage in older adults to test the hypothesis that muscle damage would be similar between EF and KE of this population. Eight old (61.6 ± 1.8 years) participants performed 5 sets of 6 maximal isokinetic (90º·s-1) eccentric contractions (ECC) of the EF (range of motion: 80-20º) and KE (30-90º) with the non-dominant limb in a randomised, counterbalanced order with 2 weeks between bouts. Maximal voluntary isometric (MVC-ISO) and concentric contraction torque, optimum angle, range of motion (ROM), muscle soreness and serum creatine kinase (CK) activity were measured before, immediately after (except CK), and 24, 48, 72 and 96 hours following ECC. Normalized changes in the variables following ECC were compared between EF and KE by a mixed model analysis. The results showed that only MVC-ISO and ROM demonstrated significant group effects (p < 0.05) for the comparison between EF and KE. Additionally, no significant group vs. time interaction (p > 0.05) was found for the older adults between EF and KE for the changes in any of the dependent variables. These results suggest that the KE of older adults are relatively as susceptible to muscle damage as their EF, or at the very least, the difference between EF and KE are small for older adults / Mestrado / Atividade Fisica Adaptada / Mestre em Educação Física

Este estudo teve como objetivo investigar a influência de diferentes estágios de severidade da neuropatia diabética na velocidade de condução das fibras musculares estimada em quatro músculos do membro inferior durante contrações isométricas, utilizando-se eletromiografia de superfície. Oitenta e cinco adultos foram estudados: 16 indivíduos não diabéticos e 69 diabéticos classificados em quatro estágios de neuropatia definidos por um sistema fuzzy: ausente (n=26), leve (n=21), moderada (n=11) e grave (n=11). As velocidades de condução médias das fibras musculares do tibial anterior, gastrocnêmico medial, vasto lateral e bíceps femoral foram avaliadas utilizando uma matriz linear de eletrodos de superfície e foram comparadas entre os grupos estudados por meio de ANOVAs (p < 0,05). As velocidades de condução diminuíram significativamente no grupo com neuropatia moderada para o vasto lateral em relação aos outros grupos (18 a 21% de decréscimo), e foram menores em todos os grupos com diabetes para o tibial anterior em relação ao grupo controle (15 a 20% de decréscimo). Não só a localização anatômica distal do músculo afetou a velocidade de condução, mas também a proporção do tipo de fibras musculares, uma vez que o tibial anterior, com maior proporção de fibras do tipo I, estava com sua velocidade de condução alterada já no grupo ausente, enquanto o vasto lateral, com maior proporção de fibras do tipo II, estava com sua velocidade de condução alterada em estágios mais tardios da doença. De forma geral, os músculos do membro inferior têm diferentes suscetibilidades aos efeitos do diabetes mellitus e da neuropatia e mostram uma redução da velocidade de condução conforme a neuropatia progride / This study aimed at investigating the influence of different stages of diabetic neuropathy in the muscle fiber conduction velocities estimated in four lower limb mucles during isometric maximal voluntary contraction using surface electromyography. Eighty-five adults were studied: 16 non-diabetic individuals and 69 diabetic patients classified into four neuropathy stages, defined by a fuzzy system: absent (n=26), mild (n=21), moderate (n=11) and severe (n=11). Average muscle fiber conduction velocities of gastrocnemius medialis, tibialis anterior, vastus lateralis and biceps femoris were assessed using linear array electrodes, and the studied groups were compared by ANOVAs (p < 0.05). Conduction velocities were significantly decreased in the moderate neuropathy group for the vastus lateralis compared to other groups (from 18 to 21% decrease), and were decreased in all diabetic groups for the tibialis anterior (from 15 to 20% from control group). Not only the distal anatomical localization of the muscle affects the conduction velocity, but also the proportion of muscle fiber type, where the tibialis anterior, with greater type I fiber proportion, is affected already at the absent group while the vastus lateralis with greater type II fiber proportion is affected in later stages of the disease. Generally, the muscles of the lower limb have different responsiveness to the effects of diabetes mellitus and neuropathy and show a reduction in the conduction velocity as the neuropathy progresses

Electric muscle stimulation (EMS) has been widely used in the rehabilitation of musculoskeletal injuries. Patterned electrical neuromuscular stimulation (PENS), a specific form of EMS, has been developed to better educate muscles to contract properly. The physiological efficacy of PENS has not been quantifiably identified. OBJECTIVES: The aim of this study is to determine the acute effect of one PENS training session (3 sets of 10 1-sec repetitions) on maximal isometric knee extensor (MVIC) torque production and surface EMG (sEMG) in healthy nonathlete college students. DESIGN: A randomized repeated-measures design was used in this study. METHODS: Twenty-two male college students participated in the study. All participants completed two training sessions, one with PENS and one without, in a randomized crossover design. RESULTS: One bout of PENS training significantly increased MVIC (3.1% ± 1.7%, p = 0.03) which was greater than the change in MVIC of the control group (p = 0.03). Control training did not alter MVIC but resulted in significant decrease in average sEMG amplitude (-7.8% ± 1.6%, p ≤ 0.01) and peak sEMG amplitude (-10.4% ± 2.7%, p ≤ 0.01). These reductions in sEMG following control training were significantly different from the PENS group (p = 0.03 and p ≤ 0.01). CONCLUSIONS: The findings suggest that strength training in conjunction with PENS can enhance torque production after just one bout of training. The increase in torque with no change in sEMG amplitude can be explained by increased motor unit synchronization or decreased cocontraction of antagonist muscles.

Context: Knee pain is a common symptom in knee pathology and is associated with alterations in quadriceps activation and movement patterns. Reducing pain through intervention may help reestablish neuromuscular function. The independent effects of knee pain are difficult to examine and unclear. Objective: To investigate the effects of transcutaneous electrical nerve stimulation (TENS) on quadriceps activation and vertical ground reaction force (VGRF) during walking. Design: Crossover. Setting: Laboratory. Subjects: 15 in the TENS group (10M and 5F, 23.5 ± 2.8 yrs, 70.5 ± 12.5 kg, 178.1 ± 7.4 cm), and 15 in the sham group (10M and 5F, 22.5 ± 2.0 yrs, 72.1 ± 13.7 kg, 177.5 ± 9.3 cm). Interventions: Subjects underwent three experimental conditions (pain, sham, and control). Measurements were recorded across four time points (preinfusion, infusion, treatment, and posttreatment). Hypertonic or isotonic saline, respectively, was infused into the infrapatellar fat pad for 48 minutes (total 7.7 mL). The TENS group received a 20-minute treatment. A sham treatment was administered to the sham group. Main Outcome Measures: Perceived knee pain on a 10-cm visual analog scale, knee extension maximum voluntary isometric contraction (MVIC) normalized to body mass, knee extension central activation ratio (CAR), and VGRF. Results: Knee pain peaked at 4 cm during infusion and remained consistent across time in the sham group (F2,28 = 49.90, P < 0.0001), while knee pain gradually decreased to 1.5 cm following TENS treatment (F2,28 = 23.11, P < 0.0001). A group x condition x time interaction was detected for both the MVIC (F6,168 = 2.92, P < 0.01) and CAR (F6,168 = 3.03, P < 0.008) measurements. Post hoc analysis revealed that the infusion of hypertonic saline reduced knee extension MVIC by 29% in the TENS group, and by 26% in the sham group (P < 0.05). However, while the MVIC remained depressed by 26% following sham treatment, the MVIC was found to improve by 12% following TENS treatment (P < 0.05). Similarly, a 10% decrease in CAR was detected in both sham and TENS groups prior to treatment. This 10% deficit held, with a 9% deficit following sham treatment, while the deficit of CAR was improved by 4% following TENS treatment (P < 0.05). For the TENS group, infusion of hypertonic saline changed VGRF at initial loading, midstance, and push-off phase. VGRF was only different at initial loading and push-off phase following TENS treatment. For the sham group however, sham treatment did not restore VGRF, showing alterations in initial loading, midstance, and push-off phase (α = 0.05). Conclusions: Infusion of hypertonic saline increased perceived knee pain, reduced knee extension MVIC, reduced CAR, and altered VGRF over some of stance phase. TENS lessened the deficits in MVIC, CAR, and VGRF, suggesting decreased muscle inhibition and improved movement function.

The uterosacral ligament (USL) and cardinal ligament (CL) are the two major suspensory tissues of the uterus, cervix, and vagina. These supportive structures can be weakened or damaged, leading to the development of pelvic floor disorders (PFDs) such as urinary incontinence, fecal incontinence, and pelvic organ prolapse. In the surgical treatment for PFDs, the USL and CL are extensively used as anchor structures to restore the normal position of the prolapsed organs. Therefore, the mechanical properties of the USL and CL may be critical for the development of new surgical reconstruction strategies for PFDs. In chapter 1, we present the first histo-mechanical characterization of the swine USL and CL using histological analysis, scanning electron microscopy and quasi-static uniaxial tensile tests. Our results suggest that the histological and uniaxial tensile properties of the swine CL and USL are very similar to those in humans. The swine is found to be a suitable animal model for studying the mechanical properties of these ligaments. To capture both the active and passive mechanical responses of biological tissues containing SMCs such as the USL and CL, a new structural constitutive model is proposed in chapter 2. The deformation of the active component in such tissues during isometric and isotonic contractions is described using an evolution law. This model is tested with published active and passive, uniaxial and biaxial, experimental data on pig arteries due to lack of data on the active properties of the USL and CL. Subjected to constant forces in-vivo, the structure and length of the USL and CL are sig- nificantly altered over time. In chapter 3, we present the first rigorous characterization of the fiber microstructure and creep properties of the USL/CL complex by using scanning electron microscopy and planar biaxial testing. Fibers are found to be oriented primarily along the main in-vivo loading direction. In such direction, the creep proceeds significantly faster under lower load. Overall, our experimental findings advance our knowledge about the passive elastic and viscoelastic properties of the USL/CL complex. The novel structural constitutive model proposed enhances our understanding of the active mechanical behavior of biological tissues containing SMCs. Knowledge about the mechanical behavior of the USL and CL from experimental and theoretical studies such as those presented here will help to improve, in the long term, the medical treatment for PFDs. / Ph. D.

O objetivo desse estudo foi verificar a relação da aptidão aeróbia e de fatores neuromusculares com o desempenho em SR em tenistas com diferentes níveis de jogo. Um grupo de dez tenistas profissionais (GP) e um grupo de dez tenistas amadores (GA) foram submetidos a quatro sessões experimentais, a saber: 1) medidas antropométricas, familiarização com o teste de drop jump (DJ) e com o teste de contração voluntária isométrica máxima (CVIM) para membros inferiores, e um teste progressivo até a exaustão; 2) um teste de DJ e um teste de carga constante para avaliar a cinética on e off do consumo de oxigênio (VO2); 3) um teste de CVIM para membros inferiores, outro teste de carga constante para avaliar a cinética on e off do VO2 e familiarização com o teste de SR; 4) um teste composto por dez SR. O GP apresentou valores significativamente menores para o tempo do melhor sprint (SRmelhor) e para a média dos tempos de todos os sprints (SRmédio) em relação ao GA (p < 0,05). O percentual de aumento do tempo ao longo dos sprints (SR%aumento) do GP não foi significativamente menor em comparação ao GA (p = 0,102), porém a chance dessa variável ser menor para o GP foi considerada \"provável\". Para o GP, a única correlação significativa observada foi entre o SRmédio e o tempo de contato obtido no teste de DJ (r = 0,641, p < 0,05). Em relação ao GA, foram observadas correlações significativas da velocidade pico obtida no teste progressivo até a exaustão com o SRmelhor (r = -0,680, p < 0,05) e SRmédio (r = -0,744, p < 0,05), assim como da amplitude da fase lenta da cinética off do VO2 com o SRmelhor (r = -0,756, p < 0,05) e SRmédio (r = -0,794, p < 0,05). Portanto, esses dados sugerem que tenistas profissionais possuem um melhor desempenho em SR em comparação aos tenistas amadores. Entretanto, não está clara a importância de fatores da aptidão aeróbia e neuromusculares no desempenho dessa atividade / The objective of this study was to verify the relationship of aerobic fitness and neuromuscular factors with RS performance in tennis players with different playing level. A group of ten professional (PG) and ten amateur (AG) tennis players were submitted to four experimental sessions, to know: 1) anthropometric measurements, familiarization with the drop jump (DJ) test and the maximal voluntary isometric contraction (MVIC) test for the lower limbs, and a progressive test until exhaustion; 2) a DJ test and a constant load test for on and off oxygen consumption (VO2) kinetics measurement; 3) a MVIC test for the lower limbs, another constant load test for on and off VO2 kinetics measurement, and familiarization with the RS test; 4) a test of ten RS. The PG presented significant lower values for the best sprint time (RSbest) and mean time of all sprints (RSmean) in relation to the AG (p < 0.05). The percentage increase in time over all sprints (RSincrease) of the PG was not significantly lower in comparison to the AG (p = 0.102), however the chance of this variable to be lower for the PG was considered \"probable\". For the PG the only significant correlation observed was between RSmean and the contact time obtained in the DJ test (r = 0.641, p < 0.05). In relation to the AG, significant correlations were observed for the peak speed obtained on the progressive test until exhaustion with the RSbest (r = -0.680, p < 0.05) and RSmean (r = -0.744, p < 0.05), likewise for the amplitude of the slow phase in oxygen uptake off-kinetics with the RSbest (r = -0.756, p < 0.05) and RSmean (r = -0.794, p < 0.05). Thus, these data suggest that professional tennis players have a better performance in RS compared to amateur tennis players. However, it is not clear the importance of aerobic fitness and neuromuscular factors in the performance of this activity