<p>Syfte</p><p>Tidigare forskning har visat att Tai Chi träning förbättrar balansen hos äldre. Syftet med denna studie var att undersöka om barns balans påverkades av träning som utfördes i ett långsamt tempo liknande Tai Chi träning.</p><p>Studien syftade också till att utreda om det förelåg någon skillnad i balans mellan pojkar och flickor och om något av könen tog till sig träningen bättre. Studien syftade även till att undersöka hur balansen påverkades då barnen utförde olika kognitiva uppgifter.</p><p>Metod</p><p>Studien fullföljdes av 41 barn i åldern 9-10 år. En interventionsgrupp, 19 barn tränade Tai Chi liknande rörelser dagligen under åtta veckor och denna jämfördes med en kontrollgrupp, 22 barn som inte fick denna träning.</p><p>Balansövningar utfördes på en kraftplatta samt på en metallprofil. Från övningarna på kraftplattan mättes standardavvikelse och amplitud av tryckcentrums mediolaterala och anterioposteriora förflyttning. Från övningarna på metallprofilen mättes antalet nedtramp.</p><p>Resultat</p><p>Många parametrar mättes men endast en uppvisade en signifikant träningseffekt. Pojkarna minskade standardavvikelsen på tryckcentrums mediolaterala förflyttning vid stående med öppna ögon.</p><p>Studien uppmätte vissa skillnader i balans mellan pojkar och flickor.</p><p>Mätningar av tryckcentrums förflyttning då barnen utförde olika uppgifter uppmätte en signifikant skillnad vid stående med öppna ögon jämfört med stående då ögonen var stängda (med eller utan utförande av en samtida kognitiv uppgift).</p><p>Övningarna på metallskenan förbättrades lika mycket i tränings- som kontrollgrupp.</p><p>Slutsats</p><p>Studien ger indikationer att träningsformen i viss utsträckning var effektiv då daglig träning under åtta veckor gav signifikant förbättring i en av de testade parametrarna.</p><p>Dessa fynd är i linje med de fåtal studier som finns på träning av balans hos barn.</p><p> </p> / <p>Aim.</p><p>Previous studies have shown that Tai Chi exercises improve postural control in elderly people. The primary aim of this study was to investigate if similar Thai Chi like training affects postural control in children. Secondary aims of the study was 1) to investigate if any such effects from training differs between boys and girls and 2) to investigate whether performing a cognitive task during balance testing had any effect on postural control in these children.</p><p>Method.</p><p>In the balance tests, different tasks were performed on a force plate and on a metal profile. From the tasks performed on the force plate, the standard deviations and amplitudes of the mediolateral and anterioposterior displacements of center of pressure were measured. From the tasks performed on the metal profile, the number of clampdowns were counted.</p><p>The study was conducted over an eight week period with 41 children in the ages 9-10 years old. The children were divided into two groups; children in the training group (n=19) who participated in Tai Chi like training every day, and children in the control group (n=22) who did not participate in this training.</p><p>Results.</p><p>The study also showed some differences in postural control between boys and girls.</p><p>When comparing the displacement in center of pressure between different two-legged tasks performed on the force plate, significantly less displacement was found in the task involving standing with open eyes compared to all tasks involving standing with closed eyes (with or without a concurrent cognitive task).</p><p>The number of clampdowns from the metal profile were reduced after the training period, to a similar extent in the control and the training groups.</p><p>Several different aspects of the postural control were measured in the study. Only one of these improved significantly with training. Boys in the intervention group showed a decrease in the standard deviation of the mediolateral displacement of the center of pressure when standing with open eyes.</p><p>Conclusion.</p><p>These results are also consistent with similar studies on postural control among children.</p><p>This study indicates that slow motion training, similar to Tai Chi, has a small but positive effect on postural control, for boys 9-10 year old, when conducted every day over an eight week period, as one of the tested parameters shows an improvement.</p><p> </p>

Syfte Tidigare forskning har visat att Tai Chi träning förbättrar balansen hos äldre. Syftet med denna studie var att undersöka om barns balans påverkades av träning som utfördes i ett långsamt tempo liknande Tai Chi träning. Studien syftade också till att utreda om det förelåg någon skillnad i balans mellan pojkar och flickor och om något av könen tog till sig träningen bättre. Studien syftade även till att undersöka hur balansen påverkades då barnen utförde olika kognitiva uppgifter. Metod Studien fullföljdes av 41 barn i åldern 9-10 år. En interventionsgrupp, 19 barn tränade Tai Chi liknande rörelser dagligen under åtta veckor och denna jämfördes med en kontrollgrupp, 22 barn som inte fick denna träning. Balansövningar utfördes på en kraftplatta samt på en metallprofil. Från övningarna på kraftplattan mättes standardavvikelse och amplitud av tryckcentrums mediolaterala och anterioposteriora förflyttning. Från övningarna på metallprofilen mättes antalet nedtramp. Resultat Många parametrar mättes men endast en uppvisade en signifikant träningseffekt. Pojkarna minskade standardavvikelsen på tryckcentrums mediolaterala förflyttning vid stående med öppna ögon. Studien uppmätte vissa skillnader i balans mellan pojkar och flickor. Mätningar av tryckcentrums förflyttning då barnen utförde olika uppgifter uppmätte en signifikant skillnad vid stående med öppna ögon jämfört med stående då ögonen var stängda (med eller utan utförande av en samtida kognitiv uppgift). Övningarna på metallskenan förbättrades lika mycket i tränings- som kontrollgrupp. Slutsats Studien ger indikationer att träningsformen i viss utsträckning var effektiv då daglig träning under åtta veckor gav signifikant förbättring i en av de testade parametrarna. Dessa fynd är i linje med de fåtal studier som finns på träning av balans hos barn. / Aim. Previous studies have shown that Tai Chi exercises improve postural control in elderly people. The primary aim of this study was to investigate if similar Thai Chi like training affects postural control in children. Secondary aims of the study was 1) to investigate if any such effects from training differs between boys and girls and 2) to investigate whether performing a cognitive task during balance testing had any effect on postural control in these children. Method. In the balance tests, different tasks were performed on a force plate and on a metal profile. From the tasks performed on the force plate, the standard deviations and amplitudes of the mediolateral and anterioposterior displacements of center of pressure were measured. From the tasks performed on the metal profile, the number of clampdowns were counted. The study was conducted over an eight week period with 41 children in the ages 9-10 years old. The children were divided into two groups; children in the training group (n=19) who participated in Tai Chi like training every day, and children in the control group (n=22) who did not participate in this training. Results. The study also showed some differences in postural control between boys and girls. When comparing the displacement in center of pressure between different two-legged tasks performed on the force plate, significantly less displacement was found in the task involving standing with open eyes compared to all tasks involving standing with closed eyes (with or without a concurrent cognitive task). The number of clampdowns from the metal profile were reduced after the training period, to a similar extent in the control and the training groups. Several different aspects of the postural control were measured in the study. Only one of these improved significantly with training. Boys in the intervention group showed a decrease in the standard deviation of the mediolateral displacement of the center of pressure when standing with open eyes. Conclusion. These results are also consistent with similar studies on postural control among children. This study indicates that slow motion training, similar to Tai Chi, has a small but positive effect on postural control, for boys 9-10 year old, when conducted every day over an eight week period, as one of the tested parameters shows an improvement.

Movement of different body segments is an essential component for the control of postural stability. Notably, balance impairment has been reported in individuals with chronic low back pain. Various impairments that are likely to affect postural control have been reported in this population, including proprioceptive deficits and altered control of movement at the lumbopelvic region. Although little is known about how movement of the lumbar spine contributes to postural control, spinal movement is likely to be part of the movement strategy when the multisegmental nature of the human body configuration is taken into consideration. The overall objective of this thesis was to investigate the changes in postural stability in individuals with chronic LBP, and the association with altered movement control at the lumbar spine. The control of postural stability was examined with different postural challenges while standing on either a flat surface or a short base. A short base was used to force the subjects to use a “hip strategy”; movement at the lumbopelvic region for postural correction. Kinematics of different body segments including the lumbar spine and hip were recorded to study the movement of the lumbopelvic region. In addition, ground reaction force data were collected with a force platform system to examine postural adjustments during various postural tasks. The studies showed that people with chronic low back pain have difficulty maintaining stance, with increased risk of overbalancing when standing on a short base without any perturbation. Altered motion of the lumbar spine was evident during both expected and unexpected postural perturbations, which indicated impairment of both anticipatory and feedback control of lumbar motion in individuals with chronic low back pain. In addition, subjects took longer to regain postural stability and made more postural adjustments during the recovery period after expected and unexpected perturbations. Together, the studies suggested significant contribution of changes in lumbar motion to postural impairment in people with chronic low back pain. In summary, these findings provide further evidence that spinal movement plays a critical role in the maintenance of postural stability, and altered control of movement affects the quality of postural control in individuals with chronic low back pain.

Estudos prévios têm mostrado que a resposta postural automática pode ser influenciada por processamentos corticais associados com aprendizagem, experiência prévia e dica prévia. No entanto, pouco se sabe sobre como as respostas posturais de idosos são moduladas através de diferentes informações contextuais. O presente estudo objetivou investigar como a combinação de diferentes informações de contexto, dadas por experiência com tentativas prévias e dicas sobre aspectos temporais e espaciais de uma perturbação iminente, modulam respostas reativas em indivíduos idosos em comparação a adultos jovens. A tarefa consistiu em manter a postura ereta em resposta à rotação da base de suporte nos sentidos de dorsi ou plantiflexão do tornozelo, com amplitude e velocidade fixas. No Experimento 1 adultos jovens e idosos foram submetidos a quatro condições experimentais, resultantes da combinação de dica por indicação visual do sentido de rotação e de sequência de rotações, as quais eram feitas de forma aleatória ou repetitiva. No Experimento 2 foram oferecidas dicas sobre direção e/ou tempo de rotação da plataforma. Os resultados indicaram séries de tentativas com mesma direção de rotação induziram menor oscilação do centro de pressão e menor ativação muscular, enquanto que séries aleatórias induziram menor latência de ativação muscular. Dica temporal induziu latências mais curtas de ativação muscular, e dica sobre direção de perturbação induziu respostas musculares de menor magnitude (efeito observado apenas no Experimento 1). Não foi observado efeito diferencial de dicas entre os grupos etários. Os resultados sugerem que informações contextuais modulam respostas posturais reativas, e que o controle postural em indivíduos idosos é beneficiado por informações contextuais de forma similar a adultos jovens / Previous studies have shown that automatic postural responses can be influenced by cortical processing associated with learning, prior experience, and precue. However, scarce behavioral evidence has been provided about how postural responses are modulated by different contextual information in the elderly. The present investigation aimed at evaluating how different contextual information through prior experience and precueing about direction and/or time of basis of support rotation modulate reactive postural responses of elderly. The task consisted of recovering stable upright body balance in response to rotation of the support basis, inducing dorsi or plantar flexion with fixed amplitude and velocity. In Experiment 1 young and elderly people performed four experimental conditions resulting from combination of visual precue about direction of rotation and prior experience through repetitive or random sequences of trials. In Experiment 2 participants were provided with precueing about direction and/or time of platform rotation. Results showed that series of trials with the same direction of rotation induced decreased center of pressure oscillation and muscular activation, whereas random series induced shorter latencies of muscular activation. Precueing about time of platform rotation induced shorter latencies of muscular activation, and precueing about direction of rotation induced decreased muscular activation (effect observed in Experiment 1 only). No differential effect of precueing was observed between age groups. Results suggest that contextual information modulates reactive postural responses, and that elderlys reactive postural responses are benefited by contextual cues in a similar way as young adults responses

Orientador: Vania dos Santos Nunes Nogueira / Resumo: Além das complicações agudas relacionadas à hiperglicemia, os pacientes com Diabetes Mellitus terão ao decorrer da vida várias complicações crônicas que juntas contribuirão para uma maior morbidade e mortalidade nesses indivíduos. A Polineuropatia Diabética Periférica (PND) é uma dessas complicações, que além dos sintomas de parestesia e hiperestesia, bem como vários tipos de dor espontânea, pode levar a diminuição do equilíbrio postural e aumento do risco de quedas. Objetivo: realizar uma revisão sistemática para avaliar a eficácia do exercício físico pré-programado e supervisionado no tratamento complementar da PND. Métodos: foram criadas estratégias de busca gerais e adaptáveis às bases de dados eletrônicas na área da saúde EMBASE, MEDLINE, CENTRAL (Registro de Ensaios Controlados da Colaboração Cochrane), LILACS e PEDro. Nós incluímos estudos randomizados, nos quais os pacientes com PND foram alocados a participar ou não de um programa pré-determinado e supervisionado de atividade física. Os desfechos primários foram: número de quedas, melhora do risco de cair (aferida pelo Teste de Alcance Funcional (TAF), Teste Get Up and Go (TUG), Escala de Equilíbrio de Berg (EEB), estabilometria, apoio unipodal) e melhora do medo de cair (mensurada pelo Fall Efficacy Scale International – FES-I). Os desfechos homogêneos e com a mesma unidade de medida em pelo menos dois estudos foram plotados em uma metanálise, utilizando-se o software Review Manager 5.3. A qualida... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: In addition to acute complications related to hyperglycemia, patients with Diabetes Mellitus develop several chronic complications throughout life that together contribute to greater morbidity and mortality in these individuals. Peripheral Diabetic Polyneuropathy (PND) is one of these complications, which, in addition to symptoms of paresthesia and hyperesthesia, and several types of spontaneous pain, can lead to a decrease in postural balance and an increased risk of falls. Objective: We performed a systematic review to evaluate the effectiveness of pre-programmed and supervised physical activity in the complementary treatment of PND. Methods: General and adaptive search strategies were created for electronic databases in the health area; Embase, Medline, CENTRAL-Cochrane, Lilacs, and PEDro. We included randomized trials in which patients with PND were allocated to participate or not in a pre-determined and supervised program of physical activity. The primary outcomes were: number of falls, improvement in the risk of falls (measured by the Functional Reach Test (FRT), Get Up and Go Test (TUG), Berg Balance Scale (BBS), stabilometry, and one leg stance test) and improvement in fear of falling (measured by the Fall Efficacy Scale International – FES-I). The homogeneous outcomes, with the same unit of measurement in at least two studies were plotted in a meta-analysis, using the software Review Manager 5.3. The quality of evidence was generated in accordance w... (Complete abstract click electronic access below) / Doutor

As palmilhas posturais são órteses plantares e foram desenvolvidas por Bourdiol um pouco antes de 1980. Seu princípio está fundamentado na ação de peças podais, as quais são chamadas de elementos, barras, cunhas e calços, que são colocados sob a pele e os músculos plantares, reprogramando a postura. Na avaliação postural são observadas as variáveis descritas no protocolo CNT (assimetria dos membros superiores, assimetria das cristas ilíacas, assimetrias das Espinhas Ilíacas Póstero- Superiores - EIPS, etc.). A postura corporal é descrita como um processo de inter-relacionamento relativo das partes do corpo, havendo equilíbrio entre os ossos, músculos, tendões e ligamentos, estruturas que sustentam e protegem o corpo contra agentes externos ou internos. O objetivo deste estudo foi verificar os efeitos das palmilhas posturais sobre a postura corporal de escolares. Os objetivos específicos foram descrever as características posturais dos participantes durante a utilização das palmilhas posturais e verificar as alterações da pressão plantar dos escolares, durante a utilização das palmilhas. Foram avaliados 6 alunos da 3° série do ensino fundamental da Rede Particular da cidade de Porto Alegre – RS, todos do sexo masculino. Para a coleta de dados foi utilizada a avaliação postural através do Programa computacional para avaliação postural (PCAP) e através de um baropodômetro eletrônico. Os escolares foram avaliados pelo protocolo CNT, e através desta avaliação foram definidas quais peças podais seriam utilizadas na confecção das palmilhas. Os escolares foram avaliados primeiramente sem usar as palmilhas posturais, e em seguida fazendo uso das palmilhas, para fins de comparação. Os resultados da avaliação postural demonstraram alterações na postura corporal dos escolares em relação ao protocolo CNT ao utilizar as palmilhas posturais. E os resultados obtidos através do teste de Wilcoxon, com o nível de significância de 5% apontaram diferença significativa na avaliação da pressão plantar na região posterior do pé esquerdo ao utilizar as palmilhas posturais. Conclui-se que a utilização das palmilhas posturais provoca alteração na postura corporal de escolares, e que a pressão plantar apresenta mudanças ao utilizar as palmilhas posturais, com diferença estatisticamente significativa na região posterior do pé esquerdo (p=0,028). As outras regiões do pé apresentaram uma melhor distribuição das pressões, porém seus dados não foram estatisticamente significativos. / Postural insoles are plantar orthosis developed by Bourdiol some time before 1980. Its principle is based on the action of podal pieces, which are called elements, bars, wedges and chocks that are placed under the skin and the plantar muscles, reprogramming the body posture. In postural evaluation, the variables described in CNT protocol are observed. The body posture is described as a process of relative inter-relationship of the body parts, balancing bones, muscles, tendons and ligaments, structures that support and protect the body against external or internal agents. The aim of this study was to verify the effect of postural insoles on the body posture of schoolchildren. The specific objectives had been to describe the postural characteristics of the subjects before and after the use of postural insoles and to verify the alterations on the plantar pressure of schoolchildren, before and after the use of the insoles. Six male pupils attending the third grade of elementary school from the city of Porto Alegre - RS had been evaluated. For the data collection, postural evaluation was analyzed through a computational program for postural evaluation (CPPE) and through an electronic baropodometer. The schoolchildren were evaluated by CNT protocol, and through this evaluation were defined which podal pieces would be used in the confection of the insoles. The schoolchildren had been first evaluated without the use of postural insoles, and after that making use of the insoles, for comparison reasons. The results of the postural evaluation demonstrate body posture alterations on schoolchildren when using the insoles. The results obtained through the Wilcoxon test, with 5% of significance, point statistical difference in the evaluation of the plantar pressure in the posterior region of the left foot when using the postural insoles. One can conclude that the use of postural insoles causes alteration in the body posture of schoolchildren. Also, that the plantar pressure presents changes when postural insoles are used, with statistical significance in the posterior region of the left foot (p=0,028). Other regions of the foot had presented a better pressure distribution, however its data had not been statistical significant.

Introdução: A Doença de Parkinson (DP) é uma desordem neurodegenerativa, progressiva, patologicamente caracterizada pela perda neuronal de dopamina na via nigro-estriatal e pela presença de inclusões intraneuronais de corpos de Lewy. De etiologia desconhecida é consensualmente aceita como uma doença multifatorial com determinantes genéticos, ambientais e relacionados ao envelhecimento. Constitui-se na segunda doença neurodegenerativa mais comum em idosos. Caracteriza-se clinicamente pela tríade tremor, rigidez e bradicinesia. Juntam-se a esses sinais clássicos as alterações posturais, que levam a DP a ser considerada fator de risco independente para quedas. Apesar disso, a avaliação da estabilidade postural na DP ainda permanece imprecisa e com tratamento difícil. Objetivos e métodos: O principal foco desta dissertação é a compreensão dos mecanismos envolvidos nas alterações do equilíbrio na DP. Neste sentido realizamos uma avaliação da atividade elétrica muscular através da Eletromiografia (EMG) de superfície durante a realização do Pull Test (PT), em português teste de retropulsão. Padrões de latência e amplitude de ativação dos músculos tibial anterior, gastrocnêmio e bíceps femoral foram comparados durante a realização do PT entre pacientes com DP e indivíduos hígidos. Os padrões neurofisiológicos dos pacientes com DP foram comparados com escores no PT, tendência a quedas e administração de levodopa (períodos on e off). Resultados e conclusões: Foram encontradas diferenças significantes na atividade muscular entre DP e controles durante PT. Pacientes com DP apresentaram uma menor latência de ativação muscular. Além disso, após uma repetição em sequência de 10 PT, indivíduos controles apresentaram aumento progressivo das latências, sugerindo habituação. Já os pacientes com DP mantiveram uma latência de ativação constante, ou seja não apresentaram habituação. Não foram observadas diferenças relevantes de atividade muscular entre os DPs com PT positivo e negativo, entre caidores e não caidores e após a ingestão de Levodopa o que sugere a interferência de outros fatores relacionados à estabilidade postural, que levam a quedas na DP, em virtude da natureza heterogênea desses eventos. / Background: Parkinson's disease (PD) is a neurodegenerative disorder, progressive, pathologically characterized by neuronal loss of dopamine in the nigrostriatal pathway and the presence of intraneuronal inclusions of Lewy bodies. Of unknown etiology is widely accepted as a multifactorial disease with genetical, environmental and aging determinants. It constitutes the second most common neurodegenerative disease in the elderly. It is clinically characterized by a triad of tremor, rigidity and bradykinesia. Besides these classic signs we can add postural changes, leading PD to be considered an independent risk factor to falls. Despite this, the assessment of postural stability in PD remains unclear and difficult to treat. Objective and Methods: The main focus of this dissertation is understanding the mechanisms involved in balance disorders in PD. We undertook an assessment of muscle electrical activity through surface electromyography (EMG) while performing a Pull Test (PT). Patterns of latency and amplitude of muscle activation of the tibialis anterior, gastrocnemius and biceps femoris muscles were compared during the course of PT between PD patients and healthy individuals. Neurophysiological patterns of PD patients were compared with scores on the PT, the tendency to fall and administration of levodopa (on and off periods). Results and Conclusion: Significant differences were found in muscle activity between PD and controls during PT. PD patients had a lower latency of muscle activation. Furthermore, after a repetition in sequence of 10 PT, control subjects showed a progressive increase in latency, suggesting habituation. Patients with PD a latency of activation remained constant or showed no habituation. However, there were no significant differences in muscle activity between the PDs with positive and negative PT, between fallers and non fallers and after administration of L-dopa suggesting the influence of other factors related to postural stability, leading to falls in PD, due to the heterogeneous nature of these events.

Para acompanhar o avanço tecnológico e a competitividade, faz-se necessário proporcionar ao trabalhador condições para que ele possa desenvolver suas atividades com conforto e segurança (CHIAVENATO, 1999). Entre as estratégias utilizadas destacam-se a Ergonomia e os programas educacionais que atuam nas diferentes formas de prevenção relacionadas ao trabalho (LAURELL e NORIEGA, 1989). Diferentes autores (VIEL e ESNAULT, 2000; BRANDIMILLER, 1999; GRAF, GUGGENBÜHL e KRUEGER, 1995; SOUZA, 1995 entre outros) concordam que a posição sentada estática pode gerar sobrecarga na estrutura ósteomuscular. Na busca da variabilidade postural, na posição sentada, são apontadas mudanças ergonômicas. Entretanto, Coury e Rodgher (1997), destacam que fatores biomecânicos e psicossociais também podem interferir na postura do trabalhador. Diante disso, o objetivo principal deste estudo foi verificar a interferência da Escola Postural no Trabalho (EPTRA) e do uso de mobiliário ergonômico sobre o comportamento postural na posição sentada. Os objetivos específicos foram: (1) analisar, (2) comparar e (3) classificar o comportamento postural, na posição sentada, em sete regiões corporais, em dois momentos da jornada laboral; (4) Identificar a variabilidade e repetitividade do comportamento postural, na posição sentada; (5) identificar o nível de desconforto corporal, (6) traçar um paralelo entre o desconforto corporal e o comportamento postural, na posição sentada e (7) identificar como os participantes da EPTRA perceberam sua postura corporal. Utilizou-se uma metodologia predominantemente quantitativa. Os participantes do estudo eram servidores da Justiça Federal do Rio Grande do Sul (n=142), com idade de 21 a 64 anos (x =39,28; ±9,38), dos sexos masculino e feminino que trabalhavam na posição sentada. Eles foram divididos em quatro grupos: (1) Participantes da EPTRA que não utilizavam mobiliário ergonômico; (2) Usuários de mobiliário ergonômico; (3) Participantes da EPTRA que utilizavam mobiliário ergonômico; (4) Participantes que não sofreram qualquer intervenção. A EPTRA foi composta de 26 encontros de trinta minutos, em dias pré-definidos e dois encontros personalizados no posto de trabalho. O mobiliário ergonômico foi implantado com enfoque macroergonômico e de acordo com as necessidades da instituição. Os instrumentos de medida quantitativa foram: (1) avaliação da postura sentada (APSE) e (2) escala análogo-visual de desconforto corporal. (4) Identificar a variabilidade e repetitividade do comportamento postural, na posição sentada; (5) identificar o nível de desconforto corporal, (6) traçar um paralelo entre o desconforto corporal e o comportamento postural, na posição sentada e (7) identificar como os participantes da EPTRA perceberam sua postura corporal. Utilizou-se uma metodologia predominantemente quantitativa. Os participantes do estudo eram servidores da Justiça Federal do Rio Grande do Sul (n=142), com idade de 21 a 64 anos (x =39,28; ±9,38), dos sexos masculino e feminino que trabalhavam na posição sentada. Eles foram divididos em quatro grupos: (1) Participantes da EPTRA que não utilizavam mobiliário ergonômico; (2) Usuários de mobiliário ergonômico; (3) Participantes da EPTRA que utilizavam mobiliário ergonômico; (4) Participantes que não sofreram qualquer intervenção. A EPTRA foi composta de 26 encontros de trinta minutos, em dias pré-definidos e dois encontros personalizados no posto de trabalho. O mobiliário ergonômico foi implantado com enfoque macroergonômico e de acordo com as necessidades da instituição. Os instrumentos de medida quantitativa foram: (1) avaliação da postura sentada (APSE) e (2) escala análogo-visual de desconforto corporal. Diante dos resultados apresentados pode-se inferir que os participantes da EPTRA mostraram maior variabilidade e melhor classificação do comportamento postural do que os usuários de mobiliário ergonômico. / In order to keep track of technological advances and competitiveness it becomes necessary to provide employees with good work conditions. So, they can be able to develop their activities comfortably and safely (CHIAVENATO, 1999). Amongst the used strategies are ergonomic and educational programs focusing at different prevention ways related to work (LAURELL and NORIEGA, 1989). Authors (VIEL and ESNAULT, 2000; BRANDIMILLER, 1999; GRAF, GUGGENBÜHL and KRUEGER, 1995; SOUZA, 1995 amongst others) agree that the static sitting position can generate osteomuscular overload. Researching for postural variability at the sitting position some ergonomic changes are pointed. However, Coury and Rodgher (1997) emphasize that biomechanical and social factors also can interfere at workers posture. In the face of all this background the primary objective of this study was to verify the influence of the Back School at the Workplace Program (BSWP) and the utilization of ergonomic furniture under the postural behavior of employees at the sitting position. The specific objectives were: (1) analyze, (2) compare and (3) classify the postural behavior at the sitting position in seven body regions in two different moments of the work journey; (4) identify the variability and repetitiveness of postural behavior at the sitting position; (5) identify the level of body discomfort; (6) delineate a parallel between the body discomfort and postural behavior at the sitting position and (7) identify how the BSWP participants perceived their body posture. A predominantly quantitative methodology was performed. The participants were civil servants of Federal Justice of Rio Grande do Sul (n=142), ages ranging from 21 to 64 years old (x=39,28; +-9,38) male and female genders working at the sitting position. They were divided in four groups: (1) participants of BSWP that did not utilize ergonomic furniture; (2) users of ergonomic furniture; (3) participants of BSWP that did utilize ergonomic furniture; (4) participants that did not undergo any intervention. The BSWP consisted of 26 sessions of 30 minutes each in pre-determined days and two personalized sessions at the workplace. The ergonomic furniture was set with macro ergonomic focus and according to the institution needs. The quantitative measurement instruments were: (1) assessment of the sitting posture (ASP) and (2) analogous-visual scale of body discomfort. The qualitative assessment utilized a semi-structured interview with pre-determined categories according to the quantitative variables. The inter-groups ASP results demonstrated changes in the postural behavior in participants (groups) of BSWP both at the beginning (group 1=pelvis region p<0,01*; group 3=scapular waistline region p<0,01*) and the end of work journey (group 3=scapular waistline region p=0,05* and knee region <0,01*). Group 2 showed statistical difference in cervical region (p<0,01*) and knee region (p<0,01*). Through the comparison of the postural behavior (the beginning with the end of the work journey) it was verified that groups 1 and 3 showed significant increase in the mean postural indexes while groups 2 and 4 displayed no variation. Concerning to the classification of postural behavior it was verified that groups 1 and 3 had more significant results at both the reference and higher risk postures. The analogous-visual scale showed no significant difference between groups in body discomfort. At the qualitative interview the BSWP participants mentioned a reduction in the body discomfort during the work journey and also that they have done adaptations in their workplace independently of being formerly ergonomic or not. Before the presented results it is possible to deduce that BSWP participants showed higher and better postural behavior variability and classification, respectively than the ergonomic furniture users.

Introdução: Com o aumento da idade, estudos demonstram que a população experimenta um declínio de sistemas fisiológicos participantes no controle da estabilidade postural. Dentre os métodos de avaliação descritos na literatura, encontra-se o Pull Test (PT), que é amplamente utilizado em escala mundial para avaliação do equilíbrio em indivíduos com doença de Parkinson. O teste examina a resposta do corpo a um deslocamento corporal posterior, oferecendo um identificador útil da estabilidade postural do indivíduo. O padrão de ativação muscular durante a realização do PT não foi ainda estudado. Objetivo: analisar o padrão da atividade eletromiográfica durante a realização do PT, em indivíduos hígidos acima de 40 anos de idade. Métodos: Vinte e três indivíduos hígidos realizaram o estudo eletromiográfico (EMG) de superfície dos músculos tibial anterior, gastrocnêmio medial e bíceps femoral durante a realização do PT. O PT e registros eletromiográficos foram realizados sucessivamente por 10 vezes em cada indivíduo. Os indivíduos foram também avaliados pelo Montreal Cognitive Assessment (MoCA). Resultados: O registro EMG mostrou que a atividade muscular inicia pelo tibial anterior, sendo seguida sucessivamente pelo gastrocnêmio medial e bíceps femoral. A frequência do número de passos para a manutenção da estabilidade postural foi de 93,9% para 1 ou 2 passos e 6,1% para 3 passos ou mais. A latência para ativação muscular foi relacionada com o desempenho cognitivo no MoCA. Pacientes com escores no MoCA inferior a 26 apresentavam maior latência do tibial anterior (p=0,03) e do bíceps femoral (p=0,02). Além disso, a amplitude do gastrocnêmio medial relacionou-se inversamente com o índice de massa corporal (IMC) (p=0,01). Conclusão: Constatou-se que o declínio da função executiva e o sobrepeso estão relacionados com mudanças nas respostas 12 neurofisiológicas durante a realização do PT. Os mesmos podem contribuir para prejuízos da estabilidade postural nestes indivíduos. / Background: Physiologic systems that participate of the postural stability control are impaired with aging. Pull Test (PT) is an assessment method widely worldwide utilized for evaluating the balance in individuals with Parkinson’s disease. The test examines the body’s response to a posterior bodily displacement, offering a useful identifier of the individual’s postural stability. The pattern of muscle activation during the PT has not yet been studied. Objective: the objective of this study was to analyze the pattern of electromyographic activity during the PT, in healthy individuals, over 40 years of age. Methods: Twenty three healthy individuals have carried out an electromyographic (EMG) study of the tibialis anterior, gastrocnemius medialis and biceps femoris muscles during the PT. The PT and the electromyographic recordings have been taken successively for 10 times in each individual. The individuals cognition have been assessed by the Montreal Cognitive Assessment (MoCA). Results: The EMG recording has showed that the muscle activity begins by the tibialis anterior, being successively followed by the gastrocnemius medialis and by the biceps femoris. The rate of the number of steps for keeping the postural stability was 93.9% for 1 or 2 steps, and 6.1% for 3 or more steps. The latency for muscle activation was related to the cognitive performance in the MoCA. Patients with MoCA scores lower than 26 have presented a larger latency in the tibialis anterior (p=0.03), and in the biceps femoris (p=0.02). Furthermore, the amplitude of the gastrocnemius medialis has been inversely related to the body mass index (BMI) (p=0.01). Conclusion: It has been found out that the decline in the executive function and overweight related to changes in the neurophysiologic 14 response during the taking of the PT. These may contribute for the losses of postural stability in such individuals.

The primary goal of this research was to explore attentional factors contributing to normal balance control and to determine how age-related changes in these factors constrain balance in the aging adult. Though previous research has demonstrated attentional interference between postural control and performance of cognitive tasks in young (YA) and older adults (OA), the mechanisms contributing to interference have not been identified. This study utilized as a cognitive task, a visual working memory task (the change detection task), which identified the short term working memory (or attentional) capacity limits of participants. Participants were asked to perform the cognitive task (determining a change in the color of squares in a first vs. second memory array) either in isolation or with postural tasks of increasing complexity, including quiet sitting (control), quiet stance in isolation, quiet stance (but intermixed with support surface perturbations), and support surface perturbations. YA showed a significant decline in working memory capacity between the control and perturbation condition (p<0.01) but no change in postural performance between single and dual task conditions, as determined by increased steps in response to perturbations (p<0.33). In a second set of experiments, the performance of OA was compared to YA. Results showed that OA had reduced working memory capacity on the change detection task compared to YA even in the control condition (YA: 2.8±0.6 items; OA: 1.8±0.7; p<0.001). OA showed an even greater decline than YA in memory capacity in the dual task condition (p<0.001), along with difficulty regaining balance following perturbations, evidenced by significant increases in up on toes (p<0.05) and stepping strategies (p<0.05). These results suggest that visual working memory (for simple features) and postural control share a common attentional resource that is limited and that postural control is favored over the cognitive task in YA. In OA, attentional capacity was significantly reduced and both postural and cognitive tasks were impaired in the dual task condition, suggesting that with aging even simple cognitive tasks can negatively affect balance under challenging postural conditions.