The purpose of this study was to characterize glenohumeral joint laxity and stiffness using instrumented arthrometry. To evaluate the validity of an instrumented measurement system we compared cutaneous and bone-pinned measures of laxity and stiffness that replicate previously reported in vivo methodology. Characterization of capsular laxity was achieved through determination of the sagittal plane translational area at increasing levels of quantified force. Finally, a method for increasing the objectivity of the standard manual laxity examination was developed for the orthopaedic clinician to quantify humeral head translation and capsular volume in vivo. We hypothesized that: 1) cutaneous measures could accurately predict bone-pinned measures, 2) capsular laxity would increase with increasing levels of applied force, and 3) manual cutaneous, manual bone-pinned, and force-displacement bone-pinned measures of translation would be equal. Thirty fresh frozen cadaveric shoulder specimens (mean age=70��14 years) were tested. The shoulders were thawed and mounted to a custom-made shoulder-testing apparatus. Displacement was measured using an electromagnetic tracking system. Sensors were secured cutaneously and with bone-pins to the scapula and humerus. Force-displacement testing was performed using a load applicator and manual displacement testing utilized the anterior/posterior drawer and inferior sulcus tests. A comparison of cutaneous and bone-pinned measures of laxity and stiffness revealed good to excellent criterion validity (r=0.68 to 0.79). Examination of displacement measures at increasing levels of force revealed increasing capsular laxity with symmetric directional compliance. No significant difference was observed between anterior and posterior translation (0.4 mm, p=.55), with significant differences between inferior and anterior (4.6 mm, p<.0001) and between inferior and posterior (5.1 mm, p<.0001). A comparison of manual cutaneous to bone-pinned manual and kinetic measures of translation revealed a significant difference between methods (p=.0024) and between directions (p<.0001) with no significant interaction (p=.0948). Estimations of the force required to achieve clinical end-point suggest that greater force is required in the anterior (173 N) direction compared to posterior (123 N) and inferior (121 N). We have developed two new methods to measure glenohumeral joint kinematics and reported new information regarding normal kinematics of the glenohumeral joint. / Graduation date: 2001

Objectives: To evaluate postural control in individuals with functional ankle instability using static, dynamic, and clinical balance tests. Also, to examine the relationships between the performances in each of these tests. Design: Postural control was evaluated with a single leg balance test, a balance test involving movement, and the star excursion balance test. Participants: A volunteer sample of 19 subjects with functional ankle instability and 19 uninjured control subjects. Main Outcome Measures: Center of pressure sway path length was calculated for the static and dynamic balance tests. Total reach distance was measured for the star excursion balance test. Results: Subjects with functional ankle instability demonstrated a significantly greater center of pressure sway path length in both the static and dynamic balance tests. Conclusions: Functional ankle instability may be associated with reduced postural control as demonstrated by decreased performance in static and dynamic balance tests. / Graduation date: 2003

Orientador: Claudia Saas Magalhães / Banca: Simone Appenzeller / Banca: Monica de Oliveira Orsi Gameira / Resumo: Introdução: A Hipermobilidade é definida como uma maior amplitude dos movimentos além do limite fisiológico, reconhecida em pessoas saudáveis, ginastas, acrobatas e portadores de síndrome genética com alteração no tecido conjuntivo. Recentemente, foi descrita também a associação com disautonomia, alteração da motilidade gastrointestinal e dor crônica generalizada. É mais frequente em mulheres e crianças, diminuindo a incidência com a idade. Há inquéritos populacionais relatados em crianças e adolescentes, contudo a frequência e as repercussões da hipermobilidade no adulto jovem são pouco conhecidas. Objetivo: Descrever a frequência de hipermobilidade articular em adultos jovens, por meio de um inquérito, estimando o seu impacto funcional e na qualidade de vida, por meio do questionário de saúde SF-36. Método: Foram investigados estudantes voluntários entre 18 a 25 anos de idade, provenientes de duas faculdades, de medicina e fisioterapia, que responderam ao questionário auto administrado de cinco itens sobre a hipermobilidade, atividade física e a versão brasileira do SF-36. Foi solicitada a avaliação de hipermobilidade por meio de autoexame instruído, pontuando-se os critérios de Beighton, que foram registrados pelo investigador. Estes critérios pontuam a extensão de joelhos e cotovelos maior que 180 graus, a extensão dos 5o dígitos maior que 90 graus, a aposição dos polegares na face flexora do antebraço e a extensão da coluna com as mãos espalmadas no solo. Considerou-se hipermobilidade generalizada, a pontuação maior ou igual a 4, e localizada menor que 4 pontos, sendo ambas os lados do corpo pontuadas independentemente. Resultados: Foram incluídos 388 sujeitos, sendo 299 mulheres (77,06%) e 89 homens (22,94%), mediana de idade 23 anos, com as seguintes características antropométricas: peso médio 64,5±15,7 Kg, altura média 1,66±0,09 m. O Índice de Massa corpórea (IMC) médio foi... / Abstract: Background: Hypermobility is defined as a wide range of motion beyond the physiological limits. It has been recognized in healthy people, in ballet dancers and in connective tissue genetic diseases. More recently, it has been associated to chronic widespread pain, dysautonomia, and gastrointestinal dysmotility. Approximately 25-50% of children younger than 10 years have some degree of hypermobility, it is more common in girls decreasing incidence with age. There are population-based studies in children and adolescents, but the reports of frequency and impact of hypermobility in youngsters are scarce. Objective: Describe the frequency of joint hypermobility in youngsters through a survey, to estimate its functional impact and quality of life by SF-36 health questionnaire. Methods: Volunteers from 18 to 25 years were recruited from a local medical and a physical therapy schools. They were requested to fill out a 5-parts hypermobility questionnaire, physical activity practice and the Brazilian version of the SF-36 health questionnaire. They performed an instructed self-exam to score Beighton criteria for hypermobility. Beighton criteria scores the extension beyond range of 180 degrees in the knees and elbows, extension of 5o fingers beyond 90 degrees, extension of thumbs to touch the forearms, spine flexion to touch hands opened to the ground. All data were recorded by one assessor. Results: Of the 388 subjects included, 299 were women (77.06%) and 89 men (22.94%), with a median age 23 years, mean weight 64.5 ± 15.7 Kg, mean height 1.66 ± 0.09 m. The mean body mass index (BMI) was 23.2 ± 4.5. Generalized joint hypermobility was observed in 104 (26.8%). Localized joint hypermobility was observed in 135 (34.79%) subjects. Overall, fifth finger hypermobility was the most frequent, being reported in 165 (57.47%), followed by the thumbs with 126 (32.56%), elbows and knees with 72 each (18.6%) and column with 69 (17.79%). The correlations ... / Mestre

Made available in DSpace on 2015-10-06T13:02:42Z (GMT). No. of bitstreams: 0 Previous issue date: 2015-01-13. Added 1 bitstream(s) on 2015-10-06T13:19:36Z : No. of bitstreams: 1 000847835.pdf: 869285 bytes, checksum: bf34ac5f3477aad0089c418cf1e136f5 (MD5) / Introdução: A Hipermobilidade é definida como uma maior amplitude dos movimentos além do limite fisiológico, reconhecida em pessoas saudáveis, ginastas, acrobatas e portadores de síndrome genética com alteração no tecido conjuntivo. Recentemente, foi descrita também a associação com disautonomia, alteração da motilidade gastrointestinal e dor crônica generalizada. É mais frequente em mulheres e crianças, diminuindo a incidência com a idade. Há inquéritos populacionais relatados em crianças e adolescentes, contudo a frequência e as repercussões da hipermobilidade no adulto jovem são pouco conhecidas. Objetivo: Descrever a frequência de hipermobilidade articular em adultos jovens, por meio de um inquérito, estimando o seu impacto funcional e na qualidade de vida, por meio do questionário de saúde SF-36. Método: Foram investigados estudantes voluntários entre 18 a 25 anos de idade, provenientes de duas faculdades, de medicina e fisioterapia, que responderam ao questionário auto administrado de cinco itens sobre a hipermobilidade, atividade física e a versão brasileira do SF-36. Foi solicitada a avaliação de hipermobilidade por meio de autoexame instruído, pontuando-se os critérios de Beighton, que foram registrados pelo investigador. Estes critérios pontuam a extensão de joelhos e cotovelos maior que 180 graus, a extensão dos 5o dígitos maior que 90 graus, a aposição dos polegares na face flexora do antebraço e a extensão da coluna com as mãos espalmadas no solo. Considerou-se hipermobilidade generalizada, a pontuação maior ou igual a 4, e localizada menor que 4 pontos, sendo ambas os lados do corpo pontuadas independentemente. Resultados: Foram incluídos 388 sujeitos, sendo 299 mulheres (77,06%) e 89 homens (22,94%), mediana de idade 23 anos, com as seguintes características antropométricas: peso médio 64,5±15,7 Kg, altura média 1,66±0,09 m. O Índice de Massa corpórea (IMC) médio foi... / Background: Hypermobility is defined as a wide range of motion beyond the physiological limits. It has been recognized in healthy people, in ballet dancers and in connective tissue genetic diseases. More recently, it has been associated to chronic widespread pain, dysautonomia, and gastrointestinal dysmotility. Approximately 25-50% of children younger than 10 years have some degree of hypermobility, it is more common in girls decreasing incidence with age. There are population-based studies in children and adolescents, but the reports of frequency and impact of hypermobility in youngsters are scarce. Objective: Describe the frequency of joint hypermobility in youngsters through a survey, to estimate its functional impact and quality of life by SF-36 health questionnaire. Methods: Volunteers from 18 to 25 years were recruited from a local medical and a physical therapy schools. They were requested to fill out a 5-parts hypermobility questionnaire, physical activity practice and the Brazilian version of the SF-36 health questionnaire. They performed an instructed self-exam to score Beighton criteria for hypermobility. Beighton criteria scores the extension beyond range of 180 degrees in the knees and elbows, extension of 5o fingers beyond 90 degrees, extension of thumbs to touch the forearms, spine flexion to touch hands opened to the ground. All data were recorded by one assessor. Results: Of the 388 subjects included, 299 were women (77.06%) and 89 men (22.94%), with a median age 23 years, mean weight 64.5 ± 15.7 Kg, mean height 1.66 ± 0.09 m. The mean body mass index (BMI) was 23.2 ± 4.5. Generalized joint hypermobility was observed in 104 (26.8%). Localized joint hypermobility was observed in 135 (34.79%) subjects. Overall, fifth finger hypermobility was the most frequent, being reported in 165 (57.47%), followed by the thumbs with 126 (32.56%), elbows and knees with 72 each (18.6%) and column with 69 (17.79%). The correlations ...

Esta dissertação descreve o desenvolvimento de um goniômetro de enlace indutivo para medição de ângulos articulares. O goniômetro tem por objetivo medições de ângulos até 360° e a possibilidade de medição em articulações com mais de um grau de liberdade. Para isto utiliza como base o trabalho de Laskoski (2010) e os sistemas de navegação aeronáuticas. O experimento realizado por Laskoski (2010) efetua medições até 180° as bobinas precisam estar alinhadas. Os sistemas utilizados em navegações aeronáuticas utilizam a bússola eletrônica e o automatic direction finder, estes sistemas trabalham com grandezas na ordem de quilômetros. Este experimento visa adaptar os sistemas de navegação utilizando o campo magnético para poder efetuar medições de ângulo em pequenas distâncias. Os testes foram satisfatórios comparando os erros encontrados com os resultados dos experimentos de Laskoski (2010) e Carbonaro et al. (2014). O erro máximo em uma distância de 7,5 cm é de 10,6°e o desalinhamento entre a bobinas de +20° e -20° gera um erro de no máximo 1,71°. / This dissertation describes the development of an inductive goniometer for the measurement of joint angle. The goniometer aims to measure angles up to 360 ° and the possibility of measurement in joints with more than one degree of freedom. For this it uses as base the work of Laskoski (2010) and aeronautical navigation systems. The experiment performed by Laskoski (2010) makes measurements up to 180 ° and the coils need to be aligned. The systems used in aeronautical navigations use the electronic compass and the automatic direction finder, that systems work with magnitudes in the order of kilometers. This experiment aims to adapt the navigation systems using the magnetic field to be able to measure angles at small distances. The tests were satisfactory comparing the errors found with the results of the experiments of Laskoski (2010) and Carbonaro et al. (2014). The maximum error over a distance of 7.5 cm is 10.6 ° and the misalignment between the coils of + 20 ° and -20 ° generates an error of at most 1.71 °.