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La conception des robots humanoïdes est un défi depuis plusieurs années. Les articulations de l'être humain de par leur complexité cinématique créent des mouvements difficilement reproductibles par un mécanisme. Le genou humain permet des mouvements composés de roulement et de glissement. La conception de nouvelles articulations bio-inspirées est un enjeu pour recréer avec un robot une marche anthropomorphe. Une analyse de la cinématique des genoux a été effectuée et nous proposons une solution mécanique pour reproduire cette cinématique de genoux. L'idée est de recréer un genou avec un contact roulant entre le fémur et le tibia. Les modèles géométriques, cinématiques et dynamiques et un modèle d'impact sont développés pour un robot bipède muni de ce genou à contacts roulants. L'allure de marche est étudiée sous forme d'un problème d'optimisation paramétrique sous contraintes. Les trajectoires de marche sont approximées par des fonctions mathématiques pour deux allures de marche : une allure de simple support avec impacts et une allure de double support suivi d'un simple support puis d'un impact. Des critères énergétiques permettent de comparer le robot muni du mécanisme de genoux roulants à un robot muni de genoux à liaison rotoïde. Les résultats des optimisations montrent que le genou roulant apporte une diminution du critère sthénique. L'optimisation énergétique montre que les couples articulaires sont plus faibles sur les hanches ce qui engendre une diminution de la masse des actionneurs du robot. Enfin, un gain d'énergie est possible en associant des systèmes à ressorts en parallèle sur les articulations du robot. / The design of humanoids robot has been a tricky challenge for several years. Due to the kinematic complexity of human joints, their movements are notoriously difficult to be reproduced by a mechanism. The human knees allow movements including rolling and sliding, and therefore the design of new bio-inspired robots is of utmost importance for the reproduction of anthropomorphic walking in a robot. In this thesis, the kinematic characteristics of knees were analyzed and a mechanical solution reproducing them is proposed. The geometrical, kinematic and dynamic models are created together with an impact model for a piped robot with the knees proposed. The walking is studied as of a problem of parametric optimization under constraints. The trajectories of walking are simulated approximately by mathematical functions for two gaits: one of a single support with impacts and one of double supports followed by a simple support and then an impact. Energy criteria allow comparing the robot provided with the mechanism of rolling knees and a robot provided with revolute knees connection. The results of the optimizations show that the rolling knee brings a decrease of the sthenic criterion. The energy optimization shows that the articular couples are weaker on hips what engenders a decrease of the mass of the actuators of the robot. Finally, energy gains are possible by associating spring systems.

Esta tese versa sobre a osteoartrose (OA) de joelho no idoso, a sobrecarga do cuidador, a qualidade de vida (QV) de ambos e a relação entre a díade idoso-cuidador familiar. Dessa forma, seu objetivo foi de estudar o perfil populacional e a QV de idosos com OA e de seus cuidadores familiares. O estudo foi realizado em duas fases; na primeira foram elaborados dois artigos de revisão de literatura. E, na segunda, foram elaborados três artigos empíricos, que foram do tipo quantitativo, observacional, descritivo e de corte transversal. A amostra foi constituída por 15 idosas diagnosticadas com OA de joelho e seus cuidadores familiares. Para as idosas foram aplicados o questionário sociodemográfico e clínico, a Escala Visual Analógica (EVA), o questionário Algofuncional de Lequesne, o World Health Organization Questionnaire for Quality of Life Bref Form (WHOQOL-Bref) e o questionário da relação idoso-cuidador. Para os cuidadores foram aplicados o questionário sociodemográfico e clínico, a escala Zarit Burden Interview, o WHOQOL-Bref e o questionário da relação cuidador-idoso. As idosas apresentaram média de idade de 746,4 anos, com Índice de Massa Corporal (IMC) médio de 26,91 8,85 Kg/m2, das quais 53,33% (n=8) eram casadas e moravam com os maridos, 66,6% (n=10) eram aposentadas, 60% (n=8) não praticavam atividade física e 93,3% (n=14) utilizava algum tipo de medicação. Em relação aos cuidadores, 53,3% eram homens (n=8), com média de idade de 58,5317,54 anos, com IMC médio de 25,164,80 Kg/m2, dos quais 73,33% (n=11) eram casados, 60% (n=8) não praticavam atividade física e 93,3% (n=14) eram fumantes. De forma geral, observou-se que as idosas portadoras de OA de joelho, apontaram a dor como sintoma mais identificável e que a QV está diminuída, sendo o físico o pior domínio. Em relação aos cuidadores familiares, percebeu-se presença de sobrecarga e a que a QV está diminuída. Ao comparar a QV da díade idoso-cuidador, os resultados mostraram que as idosas têm a QV mais comprometida que o cuidador, exceto no domínio relações sociais. E a relação entre o par, demonstra indícios de ser harmoniosa. Com esta tese, gerou o projeto de um programa de apoio a saúde, para indivíduos com OA e seus cuidadores buscando minimizar as repercussões da OA na vida dos idosos e minimizar a sobrecarga sofrida pelos cuidadores. / This thesis deals with the osteoarthritis (OA) of the knee in the elderly, the burden of the caregiver, the quality of life (QOL) and the relationship between the old-family caregiver dyad. That way, your goal was to study the population profile and the QOL of elderly people with OA and their family caregivers. The study was conducted in two phases, on the first were elaborated two articles of literature review. And on the second, three practical articles were developed, which were quantitative type, observational, descriptive and cross-sectional. The sample consisted of 15 older diagnosed with knee OA and their family caregivers. For the elderly have been applied the demographic questionnaire and clinical, the Visual analogue scale (EVA), Algofuncional survey of Lequesne, the World Health Organization Questionnaire for Quality of Life-Form Bref (WHOQOL-Bref) and the old relationship quiz-caregiver. For caregivers have been applied the demographic questionnaire and clinical, Zarit Burden Interview, scale the WHOQOL-Bref questionnaire and the relative caregiver-aged. The elderly showed an average age of 74 6.4 years, with body mass index (BMI) 26.91 average 8.85 Kg/m2, out of which 53.33% (n = 8) were married and lived with their husbands, 66.6% (n = 10) were retired, 60% (n = 8) did not practice physical activity and 93.3% (n = 14) used some type of medication. In relation to caregivers, 53.3% were men (n = 8), with an average age of 58.53 17.54 years, with average BMI 25.16 4.80 Kg/m2, of which 73.33% (n = 11) were married, 60% (n = 8) did not practice physical activity and 93.3% (n = 14) were smokers. In general, it is observed that the elderly patients with OA of knee, point out the pain as a symptom more identifiable and the QOL is decreased, being the worst physical domain. In relation to family caregivers, realized an increase of burden and the QOL is diminished. When comparing the QOL of the elderly carer dyad, the results show that the elderly are the most committed to the caregiver QV, except in the field social relations. And, the relationship between the pair, shows signs of being harmonious. With this thesis, the design of a health support program, for individuals with OA and their caregivers seeking to minimize the impact of OA in the lives of the elderly and minimize overhead suffered by caregivers.

Patient-specific instrumentation (PSI) in total knee arthroplasty (TKA) has been introduced to reduce instruments and surgical time and to improve implant alignment. The aim of this study was to compare TKA with patient-specific and conventional instrumentation with regard to the use of resources in the operating room (OR), alignment and patient-reported outcome. A total of 139 TKA with PSI or conventional instrumentation were included in three centers. Economic variables of the surgery (number of instrument trays, setup and cut-sewtime), radiological alignment and patient reported outcomes (VAS Pain Scale, Oxford Knee Score, EQ-5D) were assessed after 6 weeks, 6 and 12 months. There was a significant reduction of instrument trays and of time in the OR in the PSI group. The reduction varied between the centers. With strict reorganization, more than 50% of the instrument trays could be reduced while using PSI. There were no significant differences in cut-sew-time, implant position, leg axis, pain and function. The use of PSI was associated with significantly less OR resources. However, the savings did not compensate the costs for this technology.

Made available in DSpace on 2017-06-01T18:08:20Z (GMT). No. of bitstreams: 1 erica_patricia_borba_lira_uchoa.pdf: 4523264 bytes, checksum: d4dd5f77d0353ad601698587c24fda01 (MD5) Previous issue date: 2016-11-10 / This thesis deals with the osteoarthritis (OA) of the knee in the elderly, the burden of the caregiver, the quality of life (QOL) and the relationship between the old-family caregiver dyad. That way, your goal was to study the population profile and the QOL of elderly people with OA and their family caregivers. The study was conducted in two phases, on the first were elaborated two articles of literature review. And on the second, three practical articles were developed, which were quantitative type, observational, descriptive and cross-sectional. The sample consisted of 15 older diagnosed with knee OA and their family caregivers. For the elderly have been applied the demographic questionnaire and clinical, the Visual analogue scale (EVA), Algofuncional survey of Lequesne, the World Health Organization Questionnaire for Quality of Life-Form Bref (WHOQOL-Bref) and the old relationship quiz-caregiver. For caregivers have been applied the demographic questionnaire and clinical, Zarit Burden Interview, scale the WHOQOL-Bref questionnaire and the relative caregiver-aged. The elderly showed an average age of 74 ± 6.4 years, with body mass index (BMI) 26.91 average ± 8.85 Kg/m2, out of which 53.33% (n = 8) were married and lived with their husbands, 66.6% (n = 10) were retired, 60% (n = 8) did not practice physical activity and 93.3% (n = 14) used some type of medication. In relation to caregivers, 53.3% were men (n = 8), with an average age of 58.53 ± 17.54 years, with average BMI 25.16 ± 4.80 Kg/m2, of which 73.33% (n = 11) were married, 60% (n = 8) did not practice physical activity and 93.3% (n = 14) were smokers. In general, it is observed that the elderly patients with OA of knee, point out the pain as a symptom more identifiable and the QOL is decreased, being the worst physical domain. In relation to family caregivers, realized an increase of burden and the QOL is diminished. When comparing the QOL of the elderly carer dyad, the results show that the elderly are the most committed to the caregiver QV, except in the field social relations. And, the relationship between the pair, shows signs of being harmonious. With this thesis, the design of a health support program, for individuals with OA and their caregivers seeking to minimize the impact of OA in the lives of the elderly and minimize overhead suffered by caregivers. / Esta tese versa sobre a osteoartrose (OA) de joelho no idoso, a sobrecarga do cuidador, a qualidade de vida (QV) de ambos e a relação entre a díade idoso-cuidador familiar. Dessa forma, seu objetivo foi de estudar o perfil populacional e a QV de idosos com OA e de seus cuidadores familiares. O estudo foi realizado em duas fases; na primeira foram elaborados dois artigos de revisão de literatura. E, na segunda, foram elaborados três artigos empíricos, que foram do tipo quantitativo, observacional, descritivo e de corte transversal. A amostra foi constituída por 15 idosas diagnosticadas com OA de joelho e seus cuidadores familiares. Para as idosas foram aplicados o questionário sociodemográfico e clínico, a Escala Visual Analógica (EVA), o questionário Algofuncional de Lequesne, o World Health Organization Questionnaire for Quality of Life Bref Form (WHOQOL-Bref) e o questionário da relação idoso-cuidador. Para os cuidadores foram aplicados o questionário sociodemográfico e clínico, a escala Zarit Burden Interview, o WHOQOL-Bref e o questionário da relação cuidador-idoso. As idosas apresentaram média de idade de 74±6,4 anos, com Índice de Massa Corporal (IMC) médio de 26,91 ± 8,85 Kg/m2, das quais 53,33% (n=8) eram casadas e moravam com os maridos, 66,6% (n=10) eram aposentadas, 60% (n=8) não praticavam atividade física e 93,3% (n=14) utilizava algum tipo de medicação. Em relação aos cuidadores, 53,3% eram homens (n=8), com média de idade de 58,53±17,54 anos, com IMC médio de 25,16±4,80 Kg/m2, dos quais 73,33% (n=11) eram casados, 60% (n=8) não praticavam atividade física e 93,3% (n=14) eram fumantes. De forma geral, observou-se que as idosas portadoras de OA de joelho, apontaram a dor como sintoma mais identificável e que a QV está diminuída, sendo o físico o pior domínio. Em relação aos cuidadores familiares, percebeu-se presença de sobrecarga e a que a QV está diminuída. Ao comparar a QV da díade idoso-cuidador, os resultados mostraram que as idosas têm a QV mais comprometida que o cuidador, exceto no domínio relações sociais. E a relação entre o par, demonstra indícios de ser harmoniosa. Com esta tese, gerou o projeto de um programa de apoio a saúde, para indivíduos com OA e seus cuidadores buscando minimizar as repercussões da OA na vida dos idosos e minimizar a sobrecarga sofrida pelos cuidadores.

Made available in DSpace on 2017-06-01T18:29:31Z (GMT). No. of bitstreams: 1 erica_patricia_borba_lira_uchoa.pdf: 4523264 bytes, checksum: d4dd5f77d0353ad601698587c24fda01 (MD5) Previous issue date: 2016-11-10 / This thesis deals with the osteoarthritis (OA) of the knee in the elderly, the burden of the caregiver, the quality of life (QOL) and the relationship between the old-family caregiver dyad. That way, your goal was to study the population profile and the QOL of elderly people with OA and their family caregivers. The study was conducted in two phases, on the first were elaborated two articles of literature review. And on the second, three practical articles were developed, which were quantitative type, observational, descriptive and cross-sectional. The sample consisted of 15 older diagnosed with knee OA and their family caregivers. For the elderly have been applied the demographic questionnaire and clinical, the Visual analogue scale (EVA), Algofuncional survey of Lequesne, the World Health Organization Questionnaire for Quality of Life-Form Bref (WHOQOL-Bref) and the old relationship quiz-caregiver. For caregivers have been applied the demographic questionnaire and clinical, Zarit Burden Interview, scale the WHOQOL-Bref questionnaire and the relative caregiver-aged. The elderly showed an average age of 74 ± 6.4 years, with body mass index (BMI) 26.91 average ± 8.85 Kg/m2, out of which 53.33% (n = 8) were married and lived with their husbands, 66.6% (n = 10) were retired, 60% (n = 8) did not practice physical activity and 93.3% (n = 14) used some type of medication. In relation to caregivers, 53.3% were men (n = 8), with an average age of 58.53 ± 17.54 years, with average BMI 25.16 ± 4.80 Kg/m2, of which 73.33% (n = 11) were married, 60% (n = 8) did not practice physical activity and 93.3% (n = 14) were smokers. In general, it is observed that the elderly patients with OA of knee, point out the pain as a symptom more identifiable and the QOL is decreased, being the worst physical domain. In relation to family caregivers, realized an increase of burden and the QOL is diminished. When comparing the QOL of the elderly carer dyad, the results show that the elderly are the most committed to the caregiver QV, except in the field social relations. And, the relationship between the pair, shows signs of being harmonious. With this thesis, the design of a health support program, for individuals with OA and their caregivers seeking to minimize the impact of OA in the lives of the elderly and minimize overhead suffered by caregivers. / Esta tese versa sobre a osteoartrose (OA) de joelho no idoso, a sobrecarga do cuidador, a qualidade de vida (QV) de ambos e a relação entre a díade idoso-cuidador familiar. Dessa forma, seu objetivo foi de estudar o perfil populacional e a QV de idosos com OA e de seus cuidadores familiares. O estudo foi realizado em duas fases; na primeira foram elaborados dois artigos de revisão de literatura. E, na segunda, foram elaborados três artigos empíricos, que foram do tipo quantitativo, observacional, descritivo e de corte transversal. A amostra foi constituída por 15 idosas diagnosticadas com OA de joelho e seus cuidadores familiares. Para as idosas foram aplicados o questionário sociodemográfico e clínico, a Escala Visual Analógica (EVA), o questionário Algofuncional de Lequesne, o World Health Organization Questionnaire for Quality of Life Bref Form (WHOQOL-Bref) e o questionário da relação idoso-cuidador. Para os cuidadores foram aplicados o questionário sociodemográfico e clínico, a escala Zarit Burden Interview, o WHOQOL-Bref e o questionário da relação cuidador-idoso. As idosas apresentaram média de idade de 74±6,4 anos, com Índice de Massa Corporal (IMC) médio de 26,91 ± 8,85 Kg/m2, das quais 53,33% (n=8) eram casadas e moravam com os maridos, 66,6% (n=10) eram aposentadas, 60% (n=8) não praticavam atividade física e 93,3% (n=14) utilizava algum tipo de medicação. Em relação aos cuidadores, 53,3% eram homens (n=8), com média de idade de 58,53±17,54 anos, com IMC médio de 25,16±4,80 Kg/m2, dos quais 73,33% (n=11) eram casados, 60% (n=8) não praticavam atividade física e 93,3% (n=14) eram fumantes. De forma geral, observou-se que as idosas portadoras de OA de joelho, apontaram a dor como sintoma mais identificável e que a QV está diminuída, sendo o físico o pior domínio. Em relação aos cuidadores familiares, percebeu-se presença de sobrecarga e a que a QV está diminuída. Ao comparar a QV da díade idoso-cuidador, os resultados mostraram que as idosas têm a QV mais comprometida que o cuidador, exceto no domínio relações sociais. E a relação entre o par, demonstra indícios de ser harmoniosa. Com esta tese, gerou o projeto de um programa de apoio a saúde, para indivíduos com OA e seus cuidadores buscando minimizar as repercussões da OA na vida dos idosos e minimizar a sobrecarga sofrida pelos cuidadores.