Esta tese está dividida em três estudos. No estudo I desta tese, os objetivos foram descrever a cinemática tridimensional do ombro e determinar a contribuição da articulação escápulotorácica no movimento total de elevação. No estudo II, os objetivos foram descrever a atividade eletromiográfica (EMG) e o percentual de cocontração entre os músculos deltóide médio e redondo maior. No estudo III, o objetivo foi determinar o valor máximo da força de contato gleno-umeral e da força muscular. Quarenta sujeitos participaram dos estudos divididos em três grupos: pacientes com prótese total do ombro (PTO), com prótese reversa (PRO) e um grupo controle. Todos realizaram dois exercícios de reabilitação (flexão e elevação no plano escapular) usando diferentes cargas (sem carga externa, halter de 1kg e resistência elástica). A cinemática do ombro foi registrada por meio de um dispositivo eletromagnético de rastreamento, a atividade EMG foi registrada por meio de um eletromiógrafo de 16 canais e o modelo matemático utilizado foi o Delft Shoulder and Elbow Model. As análises estatísticas foram feitas por meio de ANOVAs de dois e três fatores para medidas repetidas. Foi utilizado o teste post hoc de Bonferroni e o nível de significância adotado foi de α < 0,05. Os resultados do estudo I mostram que a escápula contribui mais para o movimento total do ombro em pacientes com prótese em relação aos indivíduos saudáveis e em exercícios realizados com 1 kg e resistência elástica comparados com os exercícios sem carga externa. O ângulo de elevação glenoumeral durante a flexão foi significativamente maior no grupo PTO em comparação ao grupo PRO. O estudo II identificou maior atividade EMG do deltóide médio e posterior no grupo PTO em comparação ao grupo controle e um aumento da atividade EMG do peitoral (parte esternal) no grupo PRO em comparação ao grupo PTO e ao grupo controle. Para os outros músculos (deltóide anterior, redondo maior, peitoral maior - parte clavicular e serrátil anterior) não foram encontradas diferenças significativas entre os grupos. Para todos os músculos, exceto o serrátil anterior, a atividade EMG foi menor nos exercícios sem carga externa quando comparados aos exercícios com 1 kg e resistência elástica. Nenhum efeito principal dos fatores grupo e carga foi encontrado no percentual de cocontração. No estudo III, o grupo controle apresentou maior força de contato gleno-umeral máxima quando comparado ao grupo PTO durante a flexão, mas não foram encontradas diferenças entre os grupos de pacientes nos dois movimentos. A resistência elástica apresentou maiores valores de força de contato gleno-umeral em todos os grupos. O valor máximo da força de todos os músculos analisados variou de 0,32 N a 772 N e o manguito rotador e o deltóide foram os músculos que apresentaram os maiores valores de força em todos os grupos. A presente tese sugere que para uma mesma amplitude de movimento, os pacientes com prótese de ombro apresentarão um movimento escapular maior compensando a perda do movimento gleno-umeral. A cinemática escapular e a atividade EMG destes pacientes foram influenciadas pela implementação de cargas externas, mas não pelo tipo de carga, diferentemente das forças de contato e das forças musculares, nas quais a resistência elástica apresentou maior influência. Além disso, o percentual de cocontração não foi influenciado pelo tipo de prótese e os grupos de pacientes apresentaram menores forças de contato gleno-umeral do que o grupo controle. / This thesis is divided into three studies. In study I, the objectives were to describe shoulder three-dimensional kinematics and to determine the contribution of scapulothoracic motion in total shoulder elevation. In study II, the objectives were to describe the electromyographic activity (EMG) and the percentage of cocontraction between middle deltoid and teres major. In study III, the objective was to determine the maximum glenohumeral contact force and shoulder muscle forces. Forty subjects participated in the studies divided into three groups: patients with total shoulder prosthesis (TSP), patients with reverse shoulder prosthesis (RSP) and a control group. All patients realized two rehabilitation exercises (anteflexion and elevation in the scapular plane) using different loads (without external load, 1 kg dumbbell and elastic resistance). Shoulder kinematics was recorded by means of an electromagnetic tracking device, the EMG activity was recorded through a 16-channel EMG system and the Delft Shoulder and Elbow Model was used. Statistical analyses were performed by means of repeated measures ANOVAs. The Bonferroni post hoc test was used and the adopted significance level was α <0.05. Results of study I showed that the scapula contributes more to the total movement of the shoulder in patients with prosthesis compared to healthy subjects and in exercises performed with 1 kg and elastic resistance compared to exercises without external load. The glenohumeral elevation angle during anteflexion was significantly higher in the TSP group compared to the RSP. The study II identified higher EMG activity of the middle and posterior deltoid in the TSP group compared to the control group and an increase of EMG activity of pectoralis major (sternal part) in the RSP group compared to the TSP and the control group. For the other muscles (anterior deltoid, teres major, pectoralis major - clavicular part and serratus anterior) significant differences were not found among groups. For all muscles, except the serratus anterior, EMG activity was lower during exercises without external load compared to exercises with 1 kg and elastic resistance. No main effect of group and load was found in the percentage of cocontraction. In study III, the control group showed higher maximum glenohumeral contact force when compared to TSP group during anteflexion, but no differences were found between groups of patients during both movements. Elastic resistance exercises showed higher glenohumeral contact force in all groups. The maximum force of all analyzed muscles ranged from 0,32 N to 772 N and the rotator cuff and deltoid muscles presented the highest values in all groups. This thesis suggests that for a same range of motion, patients with shoulder prosthesis present greater scapular motion compensating the loss of glenohumeral motion. Scapular kinematics and EMG activity of these patients were affected by the implementation of external loads, but not by the type of load, unlike the contact forces and muscle forces, in which the elastic resistance had greater influence. Moreover, the percentage of cocontraction was not influenced by the type of prosthesis and patient groups had lower glenohumeral contact forces compared to the control group.

<p>Cilj istraživanja je da se dokumentuju različiti identiteti profesorki univerziteta koje su oti&scaron;le iz Srbije u razne akademske sredine u svetu i ostvarile profesionalnu karijeru.<br />Hipoteze su shodno cilju rada:<br />H-1: Prva hipoteza je da su profesorke u akademskoj dijaspori oti&scaron;le u inostranstvo kako bi uspe&scaron;no izgradile profesionalnu karijeru u vreme kada u zemlji porekla za to nisu postojali dovoljni uslovi u onim naučnim disciplinama za koje su se one opredelile.<br />H-2: Druga hipoteza je da sve profesorke u akademskoj dijaspori imaju promenljive, vi&scaron;estruke identitete.<br />H-3: Treća hipoteza je da empirijski podaci o životu profesorki u akademskoj dijaspori pomažu da se izgradi strategija saradnje profesorki iz dijaspore sa univerzitetskim centrima ovde.<br />Osnovni i kontrolni korpus za analizu čini 21 životna priča profesorki koje su obrazovanje za karijeru stekle na univerzitetima u Srbiji, a profesionalnu karijeru ostvarile u raznim zemljama Evrope i sveta. Audio zapisi snimljenog razgovora za ukupno 11 profesorki, zabeleženi tokom &scaron;est godina (2009-2015), audio zapisom (24 sata) na osnovu polustrukturiranog upitnika, transrkibovani u formu pisanog teksta (256 stranica). Kao kontrolni korpus empirijskih podatka su objavljenih 10 životnih priča profesorki sa Univerzitetu u Novom Sadu (Savić 2015). Osnovni kriterijumi za odbir žena su: da su rođene u Republici Srbiji (gde su provele detinjstvo, deo ili svo obrazovanje), a ostvarile akademsku karijeru u nekoj od zemalja sveta.<br />Podaci pokazuju da su sve profesorke uskladile profesionalni i privatni život i da je jedan hranio drugi u njihovoj uspe&scaron;noj karijeri.<br />Za profesionalni rad i za odlazak u zemlje destinacije (prijema) profesorke su imale podr&scaron;ku bračnih partnera, koja je bila neohodna, s obzirom na činjenicu da su sve profesorke u akademskoj dijaspori nailazile na brojne prepreke i izazove od momenta odlaska iz zemlje porekla i tokom građenja karijere (na primer, neke su visoko &scaron;kolovanje ponovile, ili su promenile profesiju ili oblast kojom se bave, a deo je nastavio usavr&scaron;avanje).<br />Obrazovanje je presudno i za vaspitanje potomstva - vrhunsko obrazovanje u skladu sa željama i afinitetima svoje dece.<br />Jezički identitet profesorki u akademskoj dijaspori povezan je sa profesionalnom orijentacijom vi&scaron;e nego sa nacionalnim identitetom.<br />Profesorke su se trudile da njihova deca u dijaspori nauče maternji jezik (jezike) roditelja, iako su deca rođena, ili najveći deo svog života, provode u zemlji destinacije, pa se može govoriti o dva (ili vi&scaron;e) maternjih jezika.<br />Najupečatljivija sličnost profesorki UNS i profesorki u akademskoj dijaspori je njihova jednaka želja i volja za obrazovanjem, usavr&scaron;avanjem i napredovanjem u struci i naučnom radu, bez obzira na cenu i prepreke sa kojima su suočene.<br />Takođe, jednako važna sličnost jeste diskriminacija sa kojom se susreću u građenju svojih karijera, profesorke UNS prilikom napredovanja, a profesorke u akademskoj dijaspori prilikom zaposlenja, bavljenja svojom strukom i, takođe, eventualnog napredovanja.<br />Sve profesorke u akademskoj dijaspori žele profesionalno da sarađuju sa univerzitetima i naučnim (i drugim) institucijama u Srbiji, ali ne postoji sistemsko re&scaron;enje za takvu saradnju u sada&scaron;njem trenutku u Srbiji.<br />Ženska iskustva ovde objedinjena svedoče o neiskori&scaron;ćenim resursima, izostalim u saradnji i angažmanu profesorki iz akademske dijaspore u Srbiji danas. Ona mogu dobro poslužiti za sačinjavanje dugoročne strategije o implementaciji znanja i postignuća akademskih profesorki u domaćem okuženju.<br />Značajno je &scaron;to se u okviru interdisciplinarnih rodnim studija objedinjuje problematika migracija žena, naročito povezano sa profesijama, jer je izvesno da će migracije biti dugoročna tema u budućnosti cele civilizacije. Postoje programi i predmeti koji se bave visokim obrazovanjem žena u profesijama i na kojima se izvode istraživački projekti na kojima se sakuplja empirijski materijal.<br />Mogućnost primene rezultata:<br />1. Empirijski podaci o identitetu akademski obrazovanih žena iz dijaspore, od kojih je jedan i rodni, poslužiće u teorijskoj raspravi o odnosu elemenata identiteta u odnosu na rod.<br />2. Empirijski podaci mogu dobro poslužiti u praksi za predlog strategije za saradnju, eventualni povratak, akademski usmerenih žena iz dijaspore u akademsku elitu u Republici Srbiji (i regionu biv&scaron;e Jugoslavije).<br />3. Bogaćenje postojeće baze podataka životnih priča žena u Republici Srbiji iz različitih nacionalnih zajednica koje su svoje živote ostvarile u 20. i 21. veku.<br />Rezultati doktorske disertacije treba da posluže u razvijanju strategije o implementaciji postignuća akademskih žena u domaćem okuženju.</p> / <p>Humans are asymmetric by nature. Asymmetry occurs for the reason that two<br />corresponding part of the body that are located on each side of the body&rsquo;s central axis are not identical to each other. These differences can be seen in the means of size and appearance, as well as in various functions during motoric actions. In regards to<br />professional and recreational sports, as well as rehabilitation, training efforts are directed to make one side of the body or limb identical to other side or limb, in means of shape, size and function. Thus, with training we strive not only to balance, but also to improve each side of the body, in order to act and function as a matched system.<br />There are number of specific features established with isokinetic chair based on various testing of different athletes. These specificities are related to particular sports disciplines followed by numerous typical imbalances between antagonistic muscle groups, often with bilateral difference. The data obtained on the isokinetic chair are extremely important for every athlete and coach because they enable precise training planning. The effectiveness of training both significantly increase the targeted work, and also prevents a large number of injuries, which are the greatest danger today&#39;s sport. The main objective of this research was to determine whether there is a dynamic asymmetry for judo and karate athletes of different age. The sample of participants consisted of 120 judo and karate athletes of both gender. Participants belong to groups of cadets, juniors and seniors. Eleven variables for evaluation of morphological (anthropometric) were applied. For assessing the maximum<br />muscle force flexor and extensor of the knee joint as well as the maximum force of<br />internal and external rotation of the shoulder joint isokinetic parameters was used. To<br />analyze the differences between the age, sport and gender by groups, we used univariate analysis of variance (ANOVA).<br />The research results showed that there were no statistically significant differences in the asymmetry between all groups for judo and karate athletes. However, there was a<br />significant difference in the expression of maximum force of quadriceps and the<br />hamstrings, as well as the maximum force for external and internal rotation of the<br />shoulder joint. These differences were all in favor of judo group for all age categories and gender. Yet, there were no statistically significant differences found between the<br />morphological characteristics of the left and right side of the body among all groups.<br />Based on the obtained results it can be concluded that judo and karate can be classified as sports that do not lead to the appearance of morphological nor dynamic asymmetry of its practitioners (athletes).</p>

The purpose of the study was to compare the physiological responses of skeletal muscle to a resistance training (RT) program using repetition maximum (RM) or relative intensity (RISR). Fifteen well-trained males underwent RT 3 d·wk−1 for 10 weeks in either an RM group (n = 8) or RISR group (n = 7). The RM group achieved a relative maximum each day, while the RISR group trained based on percentages. The RM group exercised until muscular failure on each exercise, while the RISR group did not reach muscular failure throughout the intervention. Percutaneous needle biopsies of the vastus lateralis were obtained pre-post the training intervention, along with ultrasonography measures. Dependent variables were: Fiber type-specific cross-sectional area (CSA); anatomical CSA (ACSA); muscle thickness (MT); mammalian target of rapamycin (mTOR); adenosine monophosphate protein kinase (AMPK); and myosin heavy chains (MHC) specific for type I (MHC1), type IIA (MHC2A), and type IIX (MHC2X). Mixed-design analysis of variance and effect size using Hedge’s g were used to assess within- and between-group alterations. RISR statistically increased type I CSA (p = 0.018, g = 0.56), type II CSA (p = 0.012, g = 0.81), ACSA (p = 0.002, g = 0.53), and MT (p < 0.001, g = 1.47). RISR also yielded a significant mTOR reduction (p = 0.031, g = −1.40). Conversely, RM statistically increased only MT (p = 0.003, g = 0.80). Between-group effect sizes supported RISR for type I CSA (g = 0.48), type II CSA (g = 0.50), ACSA (g = 1.03), MT (g = 0.72), MHC2X (g = 0.31), MHC2A (g = 0.87), and MHC1 (g = 0.59); with all other effects being of trivial magnitude (g < 0.20). Our results demonstrated greater adaptations in fiber size, whole-muscle size, and several key contractile proteins when using RISR compared to RM loading paradigms.

No description available.

Recent technological developments have implemented the use of proportional control in prosthetic hands, giving rise to the importance of appropriate myoelectric control. EMG models in the past have assumed a linear proportionality to simplify the EMG-force relationships. However, it has been shown that a non-linear EMG-force relationship may be a more effective model. This study focused on evaluating three different control algorithms for a novel myoelectric training device, consisting of a toy car controlled by EMG signals from the distal muscles in the arm. Sixteen healthy adult subjects (5 male and 11 female) with an average age of 23.6 years (SD = 2.7) were asked to drive the car through a slalom course. Completion times as well as number of errors (wall hits, cone hits, and reversals) were recorded to evaluate performance. The NASA TLX was administered to evaluate psychometrics such as mental demand, physical demand, frustration, and overall workload. The average total errors per trial on the final day of testing using the linear proportional algorithm was found to be statistically significantly (p < 0.05) lower than digital and non-linear proportional. The average course completion time per trial and overall workload using the non-linear proportional algorithm was found to be statistically significantly (p < 0.05) lower than digital and linear proportional. These results suggest that a non-linear algorithm would be most appropriate for myoelectric control in prosthetic hands.

Introduction: Bone strength is dependent on stimulation by skeletal muscles. To diagnose reduced bone strength and density in children and adolescents is therefore important not only to assess the physical and geometric parameters of bones using densitometric methods, but also to objectively assess parameters of muscle function. "Jumping mechanography" is one of the new techniques used for assessment of muscle force and power. The aim of the thesis was to create the gender-specific pediatric reference data on the main parameters of mechanography, muscle force (Fmax) and muscle power (Pmax). And to increase our knowledge of mechanography by defining relations between indicators mentioned above and basic anthropometrical parameters. Material and Methods: The study population included 796 healthy individuals (432 girls and 364 boys) aged 6-18 years. All probands were examined by a "single two-legged jump" and they were measured for their height and body mass. "Multiple one-legged hopping" was performed in a subgroup of 376 children. The participants were recruited from five primary schools and three high schools. Motoric tests were performed using a portable force platform ("Leonardo Mechanograph® GRFP", Novotec Medical GmbH, Pforzheim). LMS method was used to generate smooth centile curves for parameters...

Tyrimo aktualumas: Apatinių galūnių amputacija turi įtakos žmogaus mobilumui, kūno vaizdo suvokimui, socialinei veiklai ir gyvenimo kokybei. Gebėjimas vaikščioti su protezu susijęs su kasdienine veikla bei mažesniu socialiniu aktyvumu (Samsan et al., 2009). Žmonės, patyrę apatinių galūnių amputaciją, patiria daug fizinių, psichologinių ir socialinių problemų, susijusių su jų galūnių praradimu, tolesne reabilitacija ir reintegracija visuomenėje (Gallagher et al., 2008). Pasirinkta tema aktuali todėl, kad svarbu nustatyti asmenų po šlaunies amputacijos savęs vertinimo lygį reabilitacijos metu, nes nuo to priklauso paciento motyvacija ir tikslų nustatymas reabilitacijos metu bei reabilitacijos rezultatai. Darbo objektas: tiriamųjų savęs vertinimas, aerobinė ištvermės, pusiausvyros, mobilumo ir raumenų jėgos pokyčiai. Darbo naujumas: asmenų po šlaunies amputacijos savęs vertinimas kineziterapijos metu bei jo ryšys kineziterapijos rezultatams yra mažai nagrinėtas, tokių darbų atlikta labai mažai. Tyrimo hipotezė: manome, kad aukštesnės savivertės asmenų po apatinės galūnės amputacijos kineziterapijos rezultatai yra geresni. Šio tyrimo tikslas: nustatyti savęs vertinimo ir kineziterapijos rezultatų ryšį po šlaunies amputacijos. Tyrimo uždaviniai: 1. Įvertinti pacientų po šlaunies amputacijos mobilumą, pusiausvyrą, aerobinę ištvermę ir raumenų jėgą prieš ir po kineziterpijos. 2. Įvertinti pacientų savęs vertinimą pagal Rosenbergo savęs vertinimo skalę prieš kineziterapiją. 3... [toliau žr. visą tekstą] / Relevance of study: Lower limb amputation not only affects people’s ability to walk, but may impact on their participation in valued activities, body image perception and quality of life. The ability to walk with a prosthesis associated with activities of daily living and reduced social activity (Samsan et al., 2009). People with lower extremity amputation face numerous physical, psychological, and social challenges associated with their limb loss and subsequent rehabilitation and community reintegration (Gallagher et al., 2008). The chosen topic is important to identify level of self – esteem patients with thigh amputation during rehabilitation, because that depend on the patient's motivation and goal setting in rehabilitation, and rehabilitation results. Object of study: subjects self – esteem, aerobic capacity, balance, mobility and muscle strength changes. Novelty of study: People with lower extremity amputation self – esteem during rehabilitation and it’s relationship to rehabilitation outcome are poorly studied, such studies have been done just few. Hypothesis of study: we believe that amputees of higher self – esteem after lower limb amputation outcomes of rehabilitation are better. Aim of study: to determine the relationship between self – esteem and results of physical therapy after thigh amputation. Tasks of the study: 1. To evaluate patients after thigh amputation mobility, balance, aerobic capacity and muscles strength before and after physical therapy. 2. To... [to full text]

Tyrimo objektas: fantominio skausmo ir raumenų jėgos pokytis po kineziterapijos ir grįžtamojo ryšio. Tyrimo tikslas: įvertini kineziterapijos ir grįžtamojo ryšio poveikį fantominiams skausmams ir šlaunies raumenų jėgai po šlaunies amputacijos. Hipotezė: manome, kad taikant kineziterapiją ir grįžtamąjį ryšį po šlaunies amputacijos, fantominių skausmų intensyvumas sumažės ir šlaunies raumenų jėga padidės labiau, nei taikant kineziterapiją be grįžtamojo ryšio. Uždaviniai: 1. Palyginti fantominių skausmų intensyvumą ir šlaunies raumenų jėgą po šlaunies amputacijos kineziterapijos pradžioje ir po įprastinės be grįžtamojo ryšio kineziterapijos. 2. Palyginti fantominių skausmų intensyvumą ir šlaunies raumenų jėgą po šlaunies amputacijos kineziterapijos pradžioje ir po kineziterapijos kartu su grįžtamuoju ryšiu. 3. Palyginti įprastinės kineziterapijos ir kineziterapijos kartu su grįžtamuoju ryšiu poveikį fantominių skausmų intensyvumui ir šlaunies raumenų jėgai. Rezultatai: Tyrimo pradžioje, kontrolinės grupės tiriamieji fantominį skausmą įvertino 6,17±0,75, tiriamosios grupės tiriamieji – 6,83±0,75 balais. Tyrimo pabaigoje, kontrolinė grupė – 5,86±0,75, tiriamoji grupė – 5,17±0,75 balais. Prieš kineziterapiją kontrolinėje grupėje, po amputacijos, šlaunį tiesiančių raumenų jėga buvo 3,00±0,00, lenkiančių – 3,33±0,52, pritraukiančių – 2,83±0,51 ir atitraukiančių – 2,50±0,55 balų; tiriamojoje grupėje, šlaunį lenkiančių raumenų jėga buvo 3,17±0,47, tiesiančių – 3,00±0,00... [toliau žr. visą tekstą] / The object: effects of physiotherapy with mirror therapy for phantom pain and thigh muscle strength after transfemoral. The objective: the alteration of phant pain and thigh muscle after physiotherapy and mirror therapy. Hyptohesis: We consider, that the application of physiotherapy with mirror therapy helps to reduce phantom pain and improve muscle strenght better than physiotherapy without mirror therapy. The aims: 1. To compare phantom pain and muscle force in the beginning of physiotherapy and after physiothepy. 2. To compare phantom pain and muscle force in the beginning of physiotherapy and after physiotherapy with mirrot therapy. 3. To compare physiotherapy with mirror therapy and physiotherapy without mirror therpy for phantom pain and muscle force. Results: Beginning of the study, the control group subjects phantom pain score 6.17 ± 0.75, experimental group subjects - 6.83 ± 0.75 points. End of the study, the control group - 5.86 ± 0.75, experimental group - 5.17 ± 0.75 points. Before physical therapy in the control group after the amputation, the thigh muscle stretching force was 3.00 ± 0.00, flexion - 3.33 ± 0.52, attracting - 2.83 ± 0.51 and distracting - 2.50 ± 0.55 scores, the experimental group, the thigh, the muscle strength was 3.17 ± 0.47, stretching - 3.00±0.00, attracting - 2.67±0.47 and distracting-2.83±0.37 points. Application of physical therapy procedures, after 3 weeks, the control group, after the amputation, the thigh flexion strength was 4.33 ± 0... [to full text]

Made available in DSpace on 2014-06-11T19:23:32Z (GMT). No. of bitstreams: 0 Previous issue date: 2007-03-22Bitstream added on 2014-06-13T18:50:44Z : No. of bitstreams: 1 sanchez_ff_dr_botfm.pdf: 1771868 bytes, checksum: 429488c50f3fd192853726c00c1fd7c1 (MD5) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / A doença pulmonar obstrutiva crônica (DPOC) apresenta manifestações sistêmicas e, dentre entre elas, as alterações nutricionais são bastante evidentes. A perda de peso e o índice de massa do corpo (IMC) foram os primeiros indicadores do estado nutricional relacionados ao prognóstico em pacientes com DPOC. Entretanto, estudos recentes ressaltam a maior prevalência da depleção da massa magra do corpo (MMC) nestes pacientes. Embora algumas repercussões da depleção da MMC em pacientes com DPOC sejam conhecidas, as informações sobre a distribuição, mecanismos e características das alterações parecem contraditórios. Alguns estudos sustentam a idéia de que a fraqueza muscular é proporcional à perda de massa muscular. Por outro lado, os resultados de estudos recentes sugerem que as alterações qualitativas ou funcionais são mecanismos, adicionais à atrofia, envolvidos na disfunção muscular de pacientes com DPOC. Outro aspecto contraditório é o envolvimento de diferentes grupos musculares; alguns estudos mostram que a função dos músculos dos membros superiores (MMSS) encontra-se relativamente preservada enquanto outros sugerem a existência de fraqueza muscular generalizada. O impacto da disfunção muscular na endurance e na tolerância ao exercício também é controverso. Os objetivos deste estudo foram avaliar a prevalência e as repercussões da depleção da massa muscular sistêmica e localizada em pacientes com DPOC. Foram avaliados sessenta e dois pacientes com DPOC atendidos no Ambulatório de Pneumologia da Faculdade de Medicina de Botucatu – UNESP; vinte e seis pacientes (VEF1: 49,0±18,0%) com depleção de MMC e trinta e seis pacientes... / Chronic obstructive pulmonary disease (COPD) presents significant systemic manifestations and, among them, the nutritional alterations are very important. Loss of body weight and the body mass index (BMI) were the first indicators of the nutritional status related to the prognosis in patients with COPD. However, recent studies have shown the predominance of the fat-free mass (FFM) depletion in these patients. Although some consequences of FFM depletion are well known, information regarding the distribution, mechanism and characteristics of the modification remains unclear. Some researches support the idea that the muscular weakness is proportional to the loss of FFM. On the other hand, results of recent investigations suggest that either the qualitative or functional alterations are mechanisms, additional to the atrophy, involved in the muscular dysfunction in patients with COPD. Another controversial aspect is related to the involvement of different muscular groups; some findings show that the function of the upper-limb muscles are relatively preserved while others suggest the existence of generalized muscular weakness. The impact of the muscular dysfunction in the endurance function and in exercise tolerance is also controversial. The goals of this research were to evaluate the prevalence and the consequences of the systemic and peripheral FFM depletion in patients with COPD. Sixty-two patients with COPD attending to the respiratory outpatient clinic (Botucatu School of Medicine UNESP) were included in the study; twenty-six (FEV1: 49.0l18.0%) with FFM depletion and thirty-six (FEV1: 59.8l24.4%) without FFM depletion. The depletion was characterized by the presence of FFM index <15 kg/m2, for women, and <16 kg/m2, for men. Patients were, in average, 64.0l9.3 years old and 68% were male... (Complete abstract, access undermentioned eletronic address)

Orientador: Irmã Godoy / Banca: Vitor Zuniga Dourado / Banca: José Alberto Neder / Banca: José Antônio Baddini Martinez / Banca: Sérgio Rupp Paiva / Resumo: A doença pulmonar obstrutiva crônica (DPOC) apresenta manifestações sistêmicas e, dentre entre elas, as alterações nutricionais são bastante evidentes. A perda de peso e o índice de massa do corpo (IMC) foram os primeiros indicadores do estado nutricional relacionados ao prognóstico em pacientes com DPOC. Entretanto, estudos recentes ressaltam a maior prevalência da depleção da massa magra do corpo (MMC) nestes pacientes. Embora algumas repercussões da depleção da MMC em pacientes com DPOC sejam conhecidas, as informações sobre a distribuição, mecanismos e características das alterações parecem contraditórios. Alguns estudos sustentam a idéia de que a fraqueza muscular é proporcional à perda de massa muscular. Por outro lado, os resultados de estudos recentes sugerem que as alterações qualitativas ou funcionais são mecanismos, adicionais à atrofia, envolvidos na disfunção muscular de pacientes com DPOC. Outro aspecto contraditório é o envolvimento de diferentes grupos musculares; alguns estudos mostram que a função dos músculos dos membros superiores (MMSS) encontra-se relativamente preservada enquanto outros sugerem a existência de fraqueza muscular generalizada. O impacto da disfunção muscular na endurance e na tolerância ao exercício também é controverso. Os objetivos deste estudo foram avaliar a prevalência e as repercussões da depleção da massa muscular sistêmica e localizada em pacientes com DPOC. Foram avaliados sessenta e dois pacientes com DPOC atendidos no Ambulatório de Pneumologia da Faculdade de Medicina de Botucatu - UNESP; vinte e seis pacientes (VEF1: 49,0±18,0%) com depleção de MMC e trinta e seis pacientes... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Chronic obstructive pulmonary disease (COPD) presents significant systemic manifestations and, among them, the nutritional alterations are very important. Loss of body weight and the body mass index (BMI) were the first indicators of the nutritional status related to the prognosis in patients with COPD. However, recent studies have shown the predominance of the fat-free mass (FFM) depletion in these patients. Although some consequences of FFM depletion are well known, information regarding the distribution, mechanism and characteristics of the modification remains unclear. Some researches support the idea that the muscular weakness is proportional to the loss of FFM. On the other hand, results of recent investigations suggest that either the qualitative or functional alterations are mechanisms, additional to the atrophy, involved in the muscular dysfunction in patients with COPD. Another controversial aspect is related to the involvement of different muscular groups; some findings show that the function of the upper-limb muscles are relatively preserved while others suggest the existence of generalized muscular weakness. The impact of the muscular dysfunction in the endurance function and in exercise tolerance is also controversial. The goals of this research were to evaluate the prevalence and the consequences of the systemic and peripheral FFM depletion in patients with COPD. Sixty-two patients with COPD attending to the respiratory outpatient clinic (Botucatu School of Medicine UNESP) were included in the study; twenty-six (FEV1: 49.0l18.0%) with FFM depletion and thirty-six (FEV1: 59.8l24.4%) without FFM depletion. The depletion was characterized by the presence of FFM index <15 kg/m2, for women, and <16 kg/m2, for men. Patients were, in average, 64.0l9.3 years old and 68% were male... (Complete abstract, access undermentioned eletronic address) / Mestre