Orientador: Manoel Barros Bértolo / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-19T16:50:55Z (GMT). No. of bitstreams: 1 Barbosa_CeciliadeMorais_M.pdf: 2147043 bytes, checksum: 3f0da4e61db88f7bc1f515b27d722a37 (MD5) Previous issue date: 2012 / Resumo: Objetivos: Avaliar o efeito do uso de palmilhas no equilíbrio e também na dor e incapacidade de idosas com osteoporose. Verificar a influência dos fatores sociodemográficos (idade, raça, escolaridade, renda familiar, estar ou não trabalhando, estado marital) e clínicos (história de fratura, idade da menopausa, índice de massa corpórea, relato de alteração visual e auditiva, uso de medicações que alteram o equilíbrio, história de quedas nos últimos 12 meses, presença de calosidades nos pés, deformidade no ante-pé, tipo de pé: normal, plano ou calvo, e tempo de uso diário da palmilha) nos resultados. Métodos: Ensaio clínico controlado e randomizado com 89 idosas com osteoporose (72.38 ±6.83 anos) em acompanhamento no ambulatório de reumatologia do Hospital de Clínicas da UNICAMP. Quarenta e quatro pacientes utilizaram palmilhas em ethinil-vinil-acetato com apoio de arco medial e botão metatarsiano durante quatro semanas e 45 pacientes foram alocadas em grupo controle sem palmilhas. Foram aplicados os instrumentos de avaliação do equilíbrio (Escala de Equilíbrio de Berg e Timed Up and Go), de dor (escala numérica) e incapacidade dos pés (Índice Manchester de Incapacidade Associada ao Pé Doloroso no Idoso) na avaliação inicial e após quatro semanas. Resultados. O grupo em uso de palmilhas apresentou melhora significativa do equilíbrio, dor e incapacidade dos pés (p<0.001), fato não observado no grupo controle. A melhora foi independente de fatores clínicos e sociodemográficos, e ainda maior naquelas que referiam alteração visual e uso de palmilhas por tempo mais prolongado. Conclusão: O uso de palmilhas esteve associado à melhora do equilíbrio, mas também de dor e incapacidade. Constitui uma estratégia simples e segura para melhora do equilíbrio e prevenção de quedas em idosas com osteoporose / Abstract: Objective: Evaluate the effect of insoles in balance, and also in pain and disability, on elderly woman with osteoporosis. Analyze the influence of some socio-demographic (age, race, education, family income, whether or not working, marital status) and clinical data (history of fractures, menopause, body mass index, visual changes, hearing impairment, medications that may alter the balance, history of falls in the last 12 months, calluses on feet, deformities in the forefoot, foot type: normal, plain or bald and use time insole) in the results. Methods: A randomized controlled clinical trial with 89 elderly women with osteoporosis (72.38 ± 6.83 years) in treatment of the outpatient clinic of the Rheumatology Division of Universidade Estadual de Campinas (UNICAMP). Forty-four patients used ethinil-vinylacetate insoles with medial arch support and metatarsal pad during four weeks and 45 patients were assigned to the control group without insoles. Balance scales (Berg Balance Scale and Timed Up and Go test), foot pain (numeric scale) and disability (Manchester Disability Index Associated with Painful Foot in the Elderly) were applied at baseline and after four weeks. Results: Only the group wearing insoles showed significant improvement in balance, foot pain and disability (p < 0.001) that was independent of socio-demographic and clinical data and greater in those with visual complains and in those with longtime insoles use. Conclusion: The use of insoles was associated with balance, but also, pain and disability improvement. It can be used as a simple and safe an adjuvant strategy to improve balance and prevent falls in elderly women / Mestrado / Mestre em Gerontologia

Within the last decade, the influence of focus of attention (FOA) instruction on postural control has been an increased interest among researchers (Yeh et al., 2016; McNevin et al., 2013). The general agreement when it comes to the role of FOA has been that adopting an external (EXT) FOA enhances the efficiency of motor programming by strengthening the relationship between movement planning and outcome, when compared to an internal (INT) FOA (see Wulf, 2013). However, increasing evidence suggests that the benefits from an EXT FOA can be mitigated by certain factors (e.g., age, skill level, novelty of the task and task complexity; Becker & Smith, 2013; Emanuel et al., 2008). As such, questions remain as to what form of FOA instruction is best suited for young learners, as FOA research has been criticized for being studied almost exclusively among adults (Agar et al., 2016). Research in this area is particularly sparse as it pertains to FOA in combination with postural control among this younger age group. This is particularly problematic as significant changes in postural control, stability and balance occur during one’s first decade in life (Haas, et al., 1989; Hay & Redon, 1999; Barela et al., 2003). Moreover, there exists some methodological concerns with regard to the lack of consistency of FOA instructions being used during experimentation. This directly influences where participants are guiding their attention and their interpretation of FOA cues (Davids, 2007; Petranek, et al., 2019). Further, the lack of replicability of traditional FOA studies and the increasing number of non-statistically significant findings in this research, calls into question the overall validity, both internal and external, regarding FOA instruction (Becker & Smith, 2013; Lawrence et al., 2011). Therefore, as a series of four complementary studies, the overall aim of this thesis is to further investigate these theoretical as well as procedural gaps. The first study examines which type of FOA instruction is best suited for two groups of young learners (typically developing children between 4-6 and 7-10 years of age) performing a postural control task. Participants will be randomized into either an INT, EXT or CTRL condition, where they will perform a postural control task with different respective visual displays. A force platform will be used to assess participants’ mediolateral centre of pressure (COP) performance, and electromyography (EMG) will be used to assess muscular activation of the participants’ major ankle stabilizers. The primary goal of study one is to investigate the influence of FOA in children by following the most common and traditional of FOA instruction. The second study serves as an extension for the first study. The aim of this study is to specifically investigate the validity and reliability of using FOA instructions, and whether or not the different attentional cues can drive their intended mental focus states. The method of this study is identical to those is Study 1 with a few major exceptions. In this case, two manipulation checks will be added to the procedure in order to assess how participants perceived, comprehended, and acted to their assigned FOA instructional condition. The first manipulation check is embedded in the structure of the trial itself: the comparison of postural control performance with and without visual information, modeled after the technique used in Yeh and colleagues (2016). The second manipulation check will be a retrospective verbal interview inspired by Perreault & French (2016). Finally, the third and fourth studies look to expand the research question from study one and two to different populations of atypically developing young learners who are known to struggle with both attention and postural control. Individuals with ADHD and individuals with DCD have been shown to interpret attentional and postural information differently when compared to age-matched controls. Therefore, the aim of these studies is to compare the differing effects of FOA across neurodiverse populations. Specifically, study three will use a group of young learners (from 4 – 10 years of age) with ADHD and study four will use a group of young learners (from 4 – 10 years of age) with DCD. The only differences in these studies compared to study one will be the lack of an age split and the use of EMG assessment. / Thesis / Master of Science in Kinesiology