FINEP; CAPES; CNPQ; Fundação Araucária; ANEEL / O presente trabalho apresenta uma aplicação de sensores à fibra ótica baseados em redes de Bragg encapsulados em compósito de resina polimérica com reforço de fibra de vidro no formato de tubo. O objetivo do trabalho foi projetar, fabricar e caracterizar o dispositivo sensor aplicado ao ciclo da marcha e a mudança do centro de gravidade em amputado transtibial, através da análise de de deformação e resistência do tubo conector da prótese transtibial. Para essa investigação foi produzido um tubo com o material compósito descrito anteriormente através do método de Moldagem por Transferência de Resina (RTM), com quatro sensores óticos. A prótese em que o tubo original foi substituído é classificada como endoesquelético, possui encaixe à vácuo, tem o tubo conector de alumínio e pé com amortecimento de fibra de carbono. O voluntário para os testes foi um homem de 41 anos, 1,65 metros de altura, 72 quilogramas e canhoto. Sua amputação ocorreu devido a trauma (secção cirúrgica nível medial feita abaixo do joelho do membro inferior esquerdo). Ele é usuário de prótese transtibial há dois anos e oito meses A caracterização dos sensores óticos e análise da deformação mecânica e resistência do tubo deu-se pelo ciclo da marcha e a variação do centro de gravidade do corpo através dos seguintes testes: levantar-se, apoiar na perna sem a prótese, apoiar na perna com a prótese, locomoção para frente e locomoção para trás. Os resultados mostram além da caracterização do ciclo da marcha em um amputado transtibial, também um elevado grau de integração das FBGs no compósito e uma alta resistência mecânica do material. / This work presents an application of optical fiber sensors based on Bragg gratings integrated to a transtibial prosthesis tube manufactured with a polymeric composite systrem of epoxy resin reinforced with glass fiber. The main objective of this study is to characterize the sensors applied to the gait cycle and changes in the gravity center of a transtibial amputee, trough the analysis of deformation and strengh of the transtibial prosthesis tube. For this investigation it is produced a tube of the composite material described above using the molding method of resin transfer (RTM) with four optical sensors. The prosthesis in which the original tube is replaced is classified as endoskeletal, has vacuum fitting, aluminium conector tube and carbon fiber foot cushioning. The volunteer for the tests was a man of 41 years old, 1.65 meters tall, 72 kilograms and left-handed. His amputation occurred due to trauma (surgical section is in the medial level, and was made below the left lower limb knee). He has been a transtibial prosthesis user for two years and eight months. The characterization of the optical sensors and analysis of mechanical deformation and tube resistance occurred through the gait cycle and the variation of the center of gravity of the body by the following tests: stand up, support leg without the prosthesis, support in the leg with the prosthesis, walk forward and walk backward. Besides the characterization of optical sensors during the gait cycle and the variation of the gravity center in a transtibial amputated, the results also showed a high degree of integration of the sensors in the composite and a high mechanical strength of the material.

Made available in DSpace on 2014-12-17T14:57:43Z (GMT). No. of bitstreams: 1 EdsonJAP.pdf: 1427766 bytes, checksum: 2d062c892b501f8f46093e7d7c17a9b2 (MD5) Previous issue date: 2007-08-10 / The manufacturing of above and below-knee prosthesis starts by taking surfac measurements of the patient s residual limb. This demands the making of a cartridg with appropriate fitting and customized to the profile of each patient. The traditiona process in public hospitals in Brazil begins with the completion of a record file (according to law n?388, of July 28, 1999 by the ministry of the health) for obtaining o the prosthesis, where it is identified the amputation level, equipment type, fitting type material, measures etc. Nowadays, that work is covered by the Brazilian Nationa Health Service (SUS) and is accomplished in a manual way being used commo measuring tapes characterizing a quite rudimentary, handmade work and without an accuracy.In this dissertation it is presented the development of a computer integrate tool that it include CAD theory, for visualization of both above and below-knee prosthesis in 3D (i.e. OrtoCAD), as well as, the design and the construction a low cos electro-mechanic 3D scanner (EMS). This apparatus is capable to automatically obtain geometric information of the stump or of the healthy leg while ensuring smalle uncertainty degree for all measurements. The methodology is based on reverse engineering concepts so that the EMS output is fed into the above mentioned academi CAD software in charge of the 3D computer graphics reconstruction of the residualimb s negative plaster cast or even the healthy leg s mirror image. The obtained results demonstrate that the proposed model is valid, because it allows the structura analysis to be performed based on the requested loads, boundary conditions, material chosen and wall thickness. Furthermore it allows the manufacturing of a prosthesis cartridge meeting high accuracy engineering patterns with consequent improvement in the quality of the overall production process / A fabrica??o de pr?teses para amputados de membros inferiores (transfemural e transtibial) exige a confec??o de um cartucho com encaixe adequado e personalizado ao perfil de cada paciente. O processo tradicional de atendimento a pacientes em hospitais p?blicos no Brasil inicia-se com o preenchimento de uma ficha conforme portaria n?388, de 28 de Julho de 1999 do minist?rio da sa?de para obten??o da pr?tese, onde ? identificado o n?vel de amputa??o, tipo de equipamento, tipo de encaixe, material, medidas etc. Atualmente, esses cartuchos s?o fabricados de forma manual atrav?s de instrumentos de baixa precis?o, caracterizando um trabalho bastante rudimentar, artesanal e sem nenhuma acuracidade. Nesta disserta??o prop?e-se o desenvolvimento de uma ferramenta integrada que envolva o CAD, para visualiza??o das pr?teses dos tipos transfemural/transtibial em 3D (OrtoCAD), bem como, o projeto e a constru??o um leitor eletromec?nico (esp?cie de scanner tridimensional), capaz de obter automaticamente e qualitativamente, com menor grau de incerteza as informa??es geom?tricas do coto ou da perna sadia. A metodologia inclui a aplica??o de conceitos de engenharia reversa para gerar computacionalmente a representa??o do coto e/ou a imagem reversa do membro sadio. Os resultados obtidos demonstram que o modelo posposto ? v?lido, pois permite a an?lise estrutural em fun??o do carregamento solicitado e a confec??o de um cartucho de pr?tese atendendo elevados padr?es de acuracidade da engenharia com conseq?ente melhoria na qualidade do processo de fabrica??o

Os objetivos desta pesquisa consistiram em contribuir para o projeto das órteses, realizar a análise cinemática do movimento de flexão/extensão do cotovelo, além de avaliar qualitativamente a independência na execução de atividades de vida diária e o ganho neurológico decorrente de um período de 6 meses de estimulação elétrica neuro-muscular (EENM). Participaram desta pesquisa oito tetraplégicos e um sujeito saudável. As órteses foram projetadas e os primeiros protótipos desenvolvidos. As avaliações cinemáticas foram realizadas durante dez tentativas do movimento de flexão/extensão do cotovelo em diferentes atividades. As avaliações qualitativas foram realizadas com os Protocolos ASIA e FIM. As órteses mostraram eficácia e funcionalidade. A avaliação cinemática mostrou que durante os movimentos com EENM houve repetibilidade, mudança no tipo de onda (de pico para retangular) e aumento do tempo de execução da atividade, comparado ao movimento voluntário. Com preensão de objeto e adição de cargas, houve alteração no padrão cinemático do movimento para a maioria dos pacientes, que indica insegurança em relação a preensão, fraqueza muscular, bem como, perturbação e incoordenação do movimento; em outros casos, houve aumento da amplitude de onda e predominância do tipo em rampa durante a EENM, o que possivelmente indica ação sinergista. Os resultados dos protocolos ASIA e FIM mostraram ganho neurológico e aumento no índice de independência funcional, para a maioria dos pacientes, decorrentes dos efeitos terapêuticos da EENM / The objectives of this research consisted of contributing for the orthosis project, to asses the knematics of the elbow flexion and extension, besides the qualitative evaluations of the independence to perform activities of daily living and neurological improvements due to a period of six months of neuromuscular electrical stimulation (NMES). Eight tetraplegics and one healthy subject participated in this study. The orthosis was projected and the first prototypes were developed. The kinematic assessment consisted of ten trials of elbow flexion and extension in different activities. The qualitative evaluations were accomplished with the ASIA and FIM Protocols. The orthosis showed effectiveness and functionality. The kinematics analysis showed that during movements with NMES there was repeatability, change in the wave form (peak to rectangular) and increase in time of performed trials, compared to the voluntary movement. With prehension of object and addition of loads, there was alteration in the kinematics pattern of the movement for most of the patients, which indicates insecurity during the prehension, muscular weakness, as well as perturbation and movement incoordination. On the others cases, there were higher wave amplitudes and wave forms mostly in ramp during NMES, which possibly indicates synergist action. The results of the ASIA e FIM Protocols showed neurological improvements and also in the index of functional independence for most of the patients due to the therapeutic effects of NMES

As décadas de 80 e 90 caracterizaram-se por ações intensas na área de saúde ocupacional. Porém os índices de acometimentos e queixas álgicas em MMSS continuam sendo um grande problema. Os trabalhadores que realizam atividades de preparação de alimentos apresentam uma grande sobrecarga em MMSS. O objetivo deste estudo foi analisar a sobrecarga musculoesquelética e o desconforto postural em trabalhadores de duas cozinhas industriais através do Método RULA e do mapa de desconforto postural. Foram filmadas e avaliadas 151 tarefas durante 10 dias em cada restaurante. Cada tarefa foi avaliada por dois observadores independentes visando a identificação do escore do método RULA e fatores que pudessem influenciar na sobrecarga musculoesquelética como mobiliário, instrumentos de trabalho, mecanização do processo de trabalho, postura (análise cinesiológica e biomecânica) e utilização de alimentos pré-processados. Os trabalhadores preencheram também o mapa de desconforto postural. Como resultado evidenciou-se que não houve diferença significativa nos escores do método RULA entre os restaurantes estudados. Porém ocorreram diferenças quando comparadas as tarefas que envolviam o preprocessamento existente em um dos restaurantes, onde foram identificados escores menores, que determinaram menor sobrecarga musculoesquelética a estes funcionários. Estes dados não provocaram diferenças significativas no resultado final de todas as tarefas, devido a influências de outros fatores fundamentais nesta análise: o mobiliário, o instrumento de trabalho e a orientação postural, não determinando diferença significativa no mapa de desconforto postural entre estas populações exceto em antebraço direito e perna direita / The decades of 80 and 90 had been characterized for intense actions in the area of occupational health. However the index of attacks and complaints in upper limbs continue being a huge problem. The workers who carry out activities of food preparation present a great overload in upper limbs. The aim of this study was to analyze the musculoskeletal overload and the postural discomfort in workers of two industrial kitchens through the RULA method and the postural discomfort map. The tasks were filmed and evaluated during 10 days in each restaurant. Each task was evaluated by two independent observers aiming to identify the results of the RULA method and factors that could influence the musculoskeletal overload, such as furniture, tools of work, mechanization of the work process, posture, and processed food use. The workers had also filled the postural discomfort map. It was seen that there was not any significant difference in the results of the RULA method between the two studied restaurants. However it was observed some differences when we compare the tasks that involved the processed food use in one of the restaurants, where it had been identified minor musculoskeletal overload to these employees. These data did not cause significant differences in the final result of all the tasks, due to the influence of other basic factors in this analysis: the furniture, the tools of work and the postural orientation. It was not determined significant difference in the postural discomfort map among these populations except right forearm and right leg

INTRODUÇÃO: Há poucos estudos bem estruturados sobre a eficácia do bloqueio anestésico do gânglio estrelado (BGE) e do bloqueio simpático torácico (BST) para o tratamento da síndrome complexa de dor regional (SCDR) do membro superior. Há evidências anatômicas e clínicas de que o BGE frequentemente não interrompe a atividade neurovegetativa simpática do membro superior. OBJETIVOS: Avaliar-se a eficácia do BST para tratar a SCDR do membro superior. CASUÍSTICA E MÉTODOS: De acordo com estudo controlado com amostra aleatória e duplamente encoberto, doentes com SCDR, com duração maior que seis meses, foram aleatoriamente submetidos ao método padronizado de tratamento (polifarmacoterapia e terapia física) associadamente aos procedimentos BST ou ao bloqueio controle. Foram comparados os aspectos demográficos, a apresentação clínica, a intensidade da dor, as alterações do humor, a qualidade de vida, a função do membro acometido e os eventos adversos dos procedimentos até um ano após sua realização. Foram utilizadas entrevistas estruturadas, o Inventário Breve de Dor (IBD), o Questionário de Dor McGill (QDM), o Questionário para Diagnóstico de Dor Neuropática (DN4), o Inventário de Sintomas de Dor Neuropática (NPSI), o questionário \"Hospital Anxiety and Depression Scale\" (HAD), o questionário de qualidade de vida WHOQOL-bref, o questionário de avaliação funcional \"Disabilities of Arm, Shoulder and Hand\" e a análise de amplitude dos movimentos (ADM) como métodos de avaliação. RESULTADOS: Foram elegíveis 63 doentes, dos quais 42 foram incluídos, destes, 36 completaram o estudo. Em 17 realizou-se o BST e em 19 o bloqueio controle. Não houve diferenças estatísticas quanto às características demográficas e clínicas entre doentes tratados com BST ou do grupo controle. Houve melhora significativa da dor em relação ao IBD \"dor agora\" e \"atividade geral\"; soma dos pontos do QDM ; questões sete, nove e 11 do NPSI nos doentes tratados com BST em relação aos doentes do grupo controle em curto prazo (um e dois meses após o bloqueio). Em longo prazo, também observou-se que ocorreu melhora significativa nos doentes tratados com BST em relação aos do grupo controle de acordo com o IBD \"dor média\", soma dos pontos QDM e questões quatro, oito e dez do NPSI um ano após o procedimento. Um ano após o procedimento evidenciou-se melhora significativa da qualidade de vida, de acordo com questões quatro, 11, 19 e 21 do WHOQOL-bref nos doentes tratados com BST em relação aos do grupo controle. Nos doentes do grupo controle evidenciouse maior pontuação de depressão de acordo com a Escala HAD em relação aso doentes tratados com BST. Nos doentes tratados com BST a ocorrência de visão turva após o procedimento foi maior que nos doentes do grupo controle. Não houve diferença estatisticamente significativa quanto a evolução funcional em curto prazo entre os dois grupos. CONCLUSÕES: Ocorreu redução significativa da percepção da dor em curto prazo (um e dois meses) e em longo prazo (um ano) e melhora da qualidade de vida e menor ocorrência de transtorno do humor, um ano após o tratamento nos doentes tratados com BST. O BST é procedimento seguro e eficaz / INTRODUCTION: There are few well-structured studies evaluating the efficacy stellate ganglion block (SGB) or the thoracic sympathetic block (TSB) for treatment of the complex regional pain syndrome (CRPS) of the upper limb. It is possible that a large proportion of SGBs does not interrupt the sympathetic activity of the upper limb. OBJECTIVES: Evaluation of the efficacy of the TSB in treatment of the CRPS of the upper limb. PATIENTS AND METHODS: Patients with CRPS I were randomly treated with polypharmacotherapy plus physical therapy and TBS or a control block. The epidemiological aspects, clinical presentation of the CRPS, severity of pain, mood abnormalities, quality of life, functionality of the affected limb, and adverse events of the interventions were evaluated. Structured interviews the Brief Pain Inventory (BPI), the McGill Pain Questionnaire (MPQ), the Neuropathic Pain Diagnostic Questionnaire (DN4), the Neuropathic Pain Symptoms Inventory (NPSI), the Hospital Anxiety and Depression Scale (HAD), the WHOQOL-BREF quality of life questionnaire, the Disabilities of Arm, Shoulder, and Hand Functional Assessment Questionnaire (DASH), and the range of movements (ROM) were the tools used for evaluation. RESULTS: Sixty-three patients were eligible, 42 were included, and 36 patients with CRPS I, lasting six months or longer completed the study. TSB 17 patients and 19 control block. There were no statistical differences in demographic or clinical characteristics between the patients of both groups. There was a significant improvement of pain according to the BPI items \"current pain\" and \"general activity\"; MPQ sum of points and NPSI questions four, seven, nine, 11 in patients treated with TSB relation to the control group shortterm (one and two months alter the block). One year after procedure according to the BPI \"average pain\", MPQ sum of points, NPSI questions four, eight and ten there was also significant pain improvement in the patients TSB treated . After one year patients treated with TSB had significant improvement of the quality of life, according to the WHOQOL-bref (items four, 11, 19, and 21), in relation to the control group, and patients of the control group had a higher depression score significant on the HAD scale in relation to those TSB treated. There was a greater incidence of blurred vision sensation, just after block, in the TSB patients. There was no statistical difference in short-term in relation to the upper limb function between the groups. CONCLUSIONS: TSB associated with drug and physical therapy treatment resulted in greater reduction of pain perception compared to control block, both in short-term (one and two months) and long-term (one year). After one year, TSB have improved quality of life and decreased the incidence of mood disorders relative to control group. TSB is a safe and effective procedure

O câncer de mama é a neoplasia maligna que mais acomete as mulheres na população brasileira. Atualmente o tratamento para o câncer de mama está fundamentado em três pilares: radioterapia, cirurgia em suas diversas técnicas, quimioterapia/hormonioterapia. A qualidade de vida pode ser afetada de uma forma geral, envolvendo os aspectos físicos, psicológicos, sociológicos, emocionais, entre outros. O objetivo deste estudo foi comparar a função do membro superior em pacientes com câncer de mama que foram submetidas à biópsia de linfonodo sentinela com as submetidas à dissecção axilar, e que não foram acompanhadas por um protocolo de reabilitação pré-estabelecido. Pacientes e métodos: foram avaliadas 36 pacientes que passaram por dissecção axilar (grupo DA), 29 que foram submetidas à biópsia de linfonodo sentinela (grupo BLS) e 11 sujeitos normais (grupo SN). Resultados: Verificamos que o grupo DA apresenta um risco de ter perda funcional para os movimentos de flexão e abdução de ombro na ordem de 5 e 3,7 vezes maior que o grupo BLS, respectivamente. Encontramos também que pacientes submetidas à BLS evoluem com disfunção significativa para a flexão e abdução de ombro quando não submetidas à intervenção fisioterápica. Conclusão: A DA apresenta uma maior disfunção em membro superior quando comparada com BLS. A reabilitação de pacientes submetidas à BLS não pode ser ignorada, pois esta intervenção cirúrgica pode levar a disfunção significativa do membro superior ipsilateral / Breast cancer is a malignancy that affects more women in the Brazilian population. Currently the treatment for breast cancer is based on three pillars: radiotherapy, surgery in its various techniques, chemotherapy / hormone therapy. Quality of life may be affected in general, involving the physical, psychological, sociological, emotional, and others. The aim of this study was to compare the upper limb function in patients with breast cancer who underwent sentinel lymph node biopsy with axillary dissection underwent, and were not accompanied by a rehabilitation protocol pre-established. Patients and methods: we evaluated 36 patients who underwent axillary dissection (group DA), 29 who underwent sentinel lymph node biopsy (SNB group) and 11 normal subjects (group SN). Results: We found that the DA group presents a risk of loss of function for flexion and shoulder abduction in the order of 5 and 3.7 times higher than the BLS group, respectively. We also found that patients who underwent SNB evolve with significant dysfunction for flexion and shoulder abduction when not undergoing physiotherapy intervention. Conclusion: The DA has a higher dysfunction in upper limb when compared with BLS. The rehabilitation of patients who underwent SNB can not be ignored because this surgery can lead to significant dysfunction of the ipsilateral upper limb

A revascularização linfática é um desafio e o estabelecimento de novas estratégias terapêuticas podem melhorar a qualidade de vida de pessoas que sofrem de distúrbios linfáticos. O objetivo deste estudo foi verificar a capacidade de tratamento com VEGFC exógeno na melhoria da vascularização linfática de uma maneira dependente do tempo em membros pélvicos (MP) de camundongos após a remoção do linfonodo inguinal. O linfonodo inguinal esquerdo foi removido cirurgicamente para mimetizar patologias com diminuição da vascularização linfática. Densidade vascular linfática (Vv) e de comprimento (Lv) foram avaliadas por imunohistoquímica, seguidas de estereologia, após a cirurgia com ou sem o tratamento com VEGFC exógeno. O grupo controle não foi manipulado, mas recebeu soro fisiológico em vez de tratamento com VEGFC exógeno. As expressões do VEGFC e FLT4 local foram avaliadas por qPCR. Houve efeito do tempo sobre Vv e Lv no Grupo Cirurgia e diferença significativa entre os grupos Controle e Cirurgia nas três regiões estudadas (região proximal, média e distal) do MP esquerdo (MPE). A Lv mostrou diferença significativa entre os grupos Controle e Cirurgia somente na região média do MPE. A Vv e a Lv para o Grupo Tratamento foram maiores do que os outros grupos em todas as regiões do MPE. A expressão gênica do VEGFC e do FLT4 apresentou efeito do tempo em todas as regiões do MPE para os grupos Cirurgia e Tratamento. Ambas as expressões gênicas do VEGFC e do FLT4 apresentaram diferença significativa entre os grupos Controle e Cirurgia, entre os grupos Cirurgia e Tratamento e entre os grupos Controle e Tratamento. Os resultados mostraram que os camundongos são bons modelos experimentais para o uso de VEGFC exógeno como terapia de revascularização linfática, e o tratamento com VEGFC exógeno aumenta vascularização linfática já após 3 dias de dano linfático. / Lymphatic revascularization is a challenge and the establishment of new therapeutic strategies may improve quality of life from those suffering from lymphatic disorders. The objective of this study was to verify the VEGFC treatment capacity in improving lymphatic vascularization in a time-dependent manner in mouse hind limb (HL) after removal of inguinal lymphnode. The left inguinal lymphnode was surgically removed to mimetize pathologies with decreased lymphatic vascularization. Lymphatic vascular density (Vv) and length (Lv) were evaluated by immunohistochemistry followed by stereology after surgery and/or VEGFC treatment. Control group was not manipulated but received saline instead of VEGFC treatment. VEGFC and FLT4 local expression were assessed by qPCR. There was effect of time over Vv and Lv in the SG and significant difference between CG and SG in the three studied regions (proximal, medium and distal region) of the left HL (LHL). The Lv showed significant difference between CG and SG only in the medium region. The Vv and the Lv for TG were higher than the other groups in all regions of LHL. VEGFC and FLT4 gene expression presented time effect in all regions of the LHL for SG and TG. Both VEGFC and FLT4 gene expression presented significant difference between CG and SG, between SG and TG, and between CG and TG. The results show that mice are good experimental models for VEGFC use as therapy for lymphatic revascularization, and VEGFC treatment increased the lymphatic vasculature already after 3 days of lymphatic damage.

Title: Motion analysis of lower extermity during squatting Aims: The aim of the thesis is to compare the squat without and with external load in a group of people who work under professional guidance and have experience with this movement, contrary to the people of the common population. Another objective will be the compasion this movement among men and women of the common population. In the theoretical part, the main objective is to describe the basic characteristic of the squat, describe the kinesiological and biomechanical findings and the risks of this movement on the locomotive apparatus. The experimental part will focus on the observation of the determined kinematic parameters of squats and their comparison in the mentioned set of persons. The results of the work should clarify the possible side effects of the squat. Methods: Kinematic analysis will be performed using Qualisys instrumentation. Infrared cameras accurately record and further perform a motion action through passive or active reflection markers. Data from the device will be processed in Microsoft Office Excel software and further evaluated statistically. Results: The results show that there are significant variations in the performance of the movement among groups of men actively engaged in squats under professional guidance and...

The aim of this study was to assess the dependency between asymmetrical weight bearing on posture. A further aim is to objectify asymmetrical weight bearing of lower limbs and asymmetrical step length while walking with the use of "Balance Master" and also to assess possibilities of usage of "Balance Master" for testing motor functions of preschool aged children. The study discusses notions such as optimal body posture, deficient body posture, and body asymmetry. Powered by TCPDF (www.tcpdf.org)

Avec le vieillissement de la population, l’Accident Vasculaire Cérébrale (AVC) est l’un des principaux problèmes de santé et touche 15 millions de personnes par an à travers le monde. Après un AVC, de nombreux troubles moteurs et sensoriels, qui ont un impact direct sur les activités de la vie quotidienne (AVQ), peuvent apparaître comme le manque de coordination, la spasticité ou les tremblements. Afin de rétablir au maximum leurs capacités motrices et sensorielles, les patients doivent suivre un processus de rééducation long et coûteux. De plus, le suivi et l’évaluation des patients se fait à partir d’observations visuelles. Peu voire aucune information objective et quantifiable sur la réalisation des exercices n’est collectée pendant les séances de rééducation. Ainsi, des informations potentiellement cruciales sur les capacités motrices des patients ne sont pas mesurées. De nombreuses plates-formes de rééducation et de suivi ont été développées pour collecter des informations objectives à l’aide de la réalité virtuelle, augmentée, d’écrans interactifs ou de dispositifs portables. Cependant, ces plates-formes peuvent présenter des contraintes de coût, de portabilité et d’utilisabilité.L’objectif de cette thèse est de proposer des outils permettant d’améliorer l’accompagnement des patients durant la rééducation fonctionnelle en offrant aux professionnels de santé un suivi plus représentatif de l’état de santé de ces derniers séance après séance. Ce suivi s’effectue à l’aide d’informations objectives et quantifiables sur les fonctions motrices des membres supérieurs collectées par des objets instrumentés de capteurs. Sur la base de l’état de l’art et des résultats d’une étude observationnelle réalisée auprès de quatorze professionnels de santé, nous avons développé cinq objets de rééducation instrumentés pour le suivi des fonctions motrices de la main et du bras et des activités de la vie quotidienne qui se matérialisent par : (i) un osselet qui collecte des informations sur la dextérité manuelle (position et pression des doigts, orientation, mouvements irréguliers, tremblements), (ii) un cube qui collecte des informations sur la préhension globale de la main (pression globale des doigts, orientation, mouvements irréguliers et tremblements), (iii) un bracelet connecté du commerce qui collecte des informations sur les fonctions motrices du bras (mouvements du bras, mouvements irréguliers et tremblements), (iv) un vêtement instrumenté qui mesure l’angle de flexion du coude et (v) un verre qui collecte des informations sur les fonctions motrices du bras et de la main lors de séquences d’actions complexes (niveau de liquide, orientation, position sur une cible, pression des doigts et tremblements) et qui permet de reconnaître les activités de la vie quotidienne boire, s’asseoir, se lever, marcher, monter et descendre des escaliers. Nous avons conduit une étude expérimentale auprès de quatorze professionnels de santé afin d'explorer l'ensemble des fonctionnalités ainsi que le design des objets afin de récolter des retours sur de possibles améliorations. Les résultats de cette étude nous ont permis s’assurer de la validité des fonctionnalités et de développer des interfaces de visualisation visant à afficher les données de manière simple, rapide et facile à interpréter. Nous avons mené une étude auprès de six professionnels de santé afin de valider le développement de ces interfaces. Les résultats indiquent que les choix de conception de ces interfaces de visualisation sont pertinents. Enfin, nous avons mené une étude expérimentale d’utilisabilité et d’acceptabilité auprès de neuf patients victimes d’AVC. Les résultats indiquent que les critères d’efficacité et de satisfaction de l’utilisabilité sont respectés. De plus, les patients ont jugé les objets faciles à utiliser et sont volontaires pour les utiliser pendant les séances de rééducation et à domicile afin d’adapter leur programme de rééducation en fonction de leurs progrès. / As the population ages, stroke is one of the major health problems affecting 15 million people worldwide each year. After a stroke, many motor and sensory disorders, which have a direct impact on activities of daily living (ADL), can appear as lack of coordination, spasticity or tremors. In order to restore their motor and sensory abilities as much as possible, patients must undergo a long and costly rehabilitation process. In addition, patient monitoring and evaluation is based on visual observations. Little or no objective and quantifiable information on the execution of exercises is collected during rehabilitation sessions. Thus, potentially crucial information on patients' motor abilities is not measured. Many rehabilitation and monitoring platforms have been developed to collect objective information using virtual reality, augmented, interactive screens or portable devices. However, these platforms may have cost, portability and usability constraints.The objective of this thesis is to propose tools to improve the accompaniment of patients during the process of functional rehabilitation by offering health professionals a more representative follow-up of the state of health of these, session after session. This monitoring is carried out using objective and quantifiable information on the motor functions of the upper limbs collected by objects instrumented with sensor. On the basis of the state of the art and the results of an observational study conducted with fourteen health professionals, we developed five instrumented rehabilitation objects for monitoring the motor functions of the hand and arm and the activities of daily life that are materialized by: (i) a jack that collects information on manual dexterity (finger position and pressure, orientation, irregular movements, tremors), (ii) a cube that collects information on overall hand grip (overall finger pressure, orientation, irregular movements and tremors), (iii) a commercially available connected watch that collects information on arm motor functions (arm movements), (iv) an instrumented garment that measures the bending angle of the elbow and (v) a cup that collects information on the motor functions of the arm and hand during complex action sequences (fluid level, orientation, position on a target, finger pressure and tremors) and allows the recognition of activities of daily living such as drinking, sitting, standing, walking, climbing and descending stairs. We conducted an experimental study with fourteen healthcare professionals to explore the functionalities and the design of the objects in order to gather feedback on possible improvements. The results of this study allowed us to tighten the measurement perimeter and make the objects more functional. This study also allowed us to develop visualization interfaces to display data in a simple, fast and easy to interpret manner. We conducted a study with six healthcare professionals to validate the development of these interfaces. The results indicate that the design choices of these visualization interfaces are relevant. Finally, we conducted an experimental usability and acceptability study in nine stroke patients. The results indicate that the efficiency and usability satisfaction criteria are met. The results show that patients found the objects easy to use and are willing to use them during rehabilitation sessions and at home to adapt their rehabilitation program according to their progress.