A Doença de Parkinson (DP) caracteriza-se por sintomas motores típicos e déficits proprioceptivos. Considerando-se o papel do estresse oxidativo na doença, o uso de agentes antioxidantes pode ter potencial terapêutico. Depois de uma revisão sobre déficits proprioceptivos na DP, esta dissertação apresenta um estudo empírico sobre o efeito da epicatequina (EC), sobre o modelo animal da 6- hidroxidopamina (6-OHDA). Ratos (n = 75) infundidos unilateralmente com 6- OHDA na via nigroestriatal receberam, após 24h, infusões intracerebrais de EC no estriado (0,031mg/mL, 0,1mg/mL, 0,31mg/mL, 1mg/mL ou veículo). O tratamento foi avaliado através dos testes de rotações induzidas por metilfenidato (40mg/kg) e apomorfina (1mg/kg), teste de motricidade sobre grade e teste da fita adesiva, além de imunoistoquímica. Os resultados mostraram que não houve diferenças entre os grupos em nenhuma das avaliações. Com base nesses resultados, concluímos que a EC, nas concentrações e condições empregadas, não foi capaz de retardar a lesão nigroestriatal ou recuperá-la. / Besides the typical motor symptoms, Parkinson´s disease (PD) is characterized by deficits in proprioception. Considering the putative role of oxidative stress in PD, antioxidants might have therapeutic value. After a review on proprioception in PD, this dissertation presents an empirical study based on the evaluation of epicatechin (EC), in 6-hydroxidopamine (6-0HDA) model of Parkinsonism. Rats (n=75) where unilaterally lesioned into the nigrostriatal pathway and treated 24h later with intracerebral infusions of EC in the striatum (0.031mg/mL, 0.1mg/mL, 0.31mg/mL, 1mg/mL or vehicle). The behavioral effects were assessed through methylphenidate (40 mg/kg) and apomorphine (1 mg/kg)-induced rotations, footfault and stick-tape tests; and brain tissue was analyzed by imunohistochemistry. There were no significant differences between groups neither in the behavioral assessments nor the histological analyses. These results showed that EC was incapable to act on either the reversal or retardation of the lesion in the nigrostriatal pathway.

INTRODUÇÃO: Atletas de futebol podem ter melhor equilíbrio que sedentários, pois os programas de treinamento sensório-motor melhoram a função motora, aumentam o controle neuromuscular e promovem a melhora da propriocepção. Este estudo teve como objetivos: avaliar o equilíbrio postural e a influência da dominância e dos fatores antropométricos em atletas de futebol de campo e indivíduos sedentários. MÉTODOS: Foram avaliados 100 indivíduos do gênero masculino divididos em dois grupos: 50 atletas de futebol de campo (GA) com idade de 18,0+0,7 anos e 50 indivíduos sedentários (GS) com idade de 17,6+0,6 anos. Os grupos foram analisados em relação à massa corporal, estatura, índice de massa corporal (IMC), flexibilidade e percentagem de gordura. Para avaliação do equilíbrio foi utilizado o protocolo Dynamic Balance System, nível 8 de estabilidade do equipamento Biodex Balance System (BBS). RESULTADOS: Os atletas apresentaram melhores índices no membro dominante no teste para a direita (p = 0,039) e no membro não-dominante no teste para trás/esquerda (p=0,007). Os sedentários tiveram melhores índices no teste realizado para a direita (p=0,034) no membro não dominante. Nos demais índices, não houve diferença estatística. O GS teve melhor desempenho do membro não dominante quando comparado com o dominante na maioria dos testes realizados. No GA houve melhor desempenho do membro não dominante no índice de estabilidade geral (p=0,027) e para esquerda (p=0,009). Houve fraca correlação entre medidas antropométricas e os índices de equilíbrio medidos pelo BBS nos dois grupos. CONCLUSÕES: Não há diferença no equilíbrio postural de atletas de futebol de campo e indivíduos sedentários. A dominância afeta o equilíbrio unipodal dos indivíduos sedentários, mas não afeta dos atletas de futebol de campo da categoria juniores. Os fatores antropométricos não interferiram no equilíbrio / INTRODUCTION: Soccer athletes may have a better balance than sedentary individuals, once sensory-motor training programs improve the motor function, increase neuromuscular control and promote a better balance and proprioception. The aim of this study was to assess the postural balance and the influence of the dominance and of anthropometric measures on field soccer athletes and sedentary individuals. METHODS: One hundred male individuals were assessed and divided in two groups: 50 field soccer players (AG) aged 18+0,7 years and 50 sedentary individuals (SG) aged 17,6+0,6 years. Groups were analyzed regarding body mass, height, body mass index (BMI), flexibility and fat percentage. Balance was assessed using the Dynamic Balance System protocol, level 8 of stability of the Biodex Balance System (BBS) equipment. RESULTS: Athletes presented better indexes in the dominant member in the test performed to the right (p=0,039), and in the non-dominant member in the test to backward/left (p=0,007). Sedentary individuals presented better indexes in the test performed to the right (p=0,034) in the non-dominant member. There was no statistical difference in the other tests. The SG presented better performance of the non-dominant member when compared to the dominant member in most of the tests performed. In the AG, there was a better performance of the non-dominant member in the overall stability index (p=0,027) and to the left (p=0,009). There was poor correlation between anthropometric measures and balance indexes measured by the BBS in both groups. CONCLUSIONS: There was no difference in postural balance between field soccer athletes and sedentary individuals. The dominance affected the unipodal balance of sedentary individuals, but not of field soccer athletes from the junior category. The anthropometric indexes did not interfere in the postural balance

Dissertation "Variability of Somatesthesis in Students of Physiotherapy " deals with somatosensorical system in its theoretical part. In the practical part, sets of tests - aimed at somatesthesis function testing - are described. These tests are easy to implement and could be objectified. This pilot study was performed on a set of 29 Subjects aged 24 - 30. Selection criteria were set to physiotherapy studies and good health condition. The research ran on FN Motol physiotherapy clinics and lasted from October 2007 until January 2008. Measurements were repeated four times (in random day time), while the interval between examinations were randomly selected 1-12 days. The methodical part closely desribes measurement procedures and performance of each test. The first aim of this dissertation was to create a set of examination tests, concentrated on somatesthesis functions, which could be objectively measured. Further we set a target to find out, if sensomotorical learning effect appears by repeated measurement of same Subject and if quality of somatesthesis functions anyhow changes depending on internal environment status. Powered by TCPDF (www.tcpdf.org)

Effect of Ankle and Foot joints mobilization on Stability improvement, analyzed by Computerized Dynamic Posturography. The aim of the study was to observe if joint mobilization of ankle and foot joints would improve the stability using the by Computerized Dynamic Posturography (neurocom) as a measurement tool. The methods that are used from the research are based on the knowledge which was obtained during the study of physiotherapy program at FTVS UK. All the participants are between the ages of 20 to 30 years, with no specific diagnose. All the 40 participants were being randomly divide into 2 groups. The control group and the experimental group, each group will have their Stability tested twice on the CPD (NeuroCom). The control group will be measured first, and after 20 minutes they will be measured again without any examination or therapeutic intervention. The experimental group was measured twice, first before the examination of joint play and the therapy, then the examination of joint play was done and any restricted joints were noted and treated, later, the participants were measured again for possible improvement. Joint play examination and therapy take about 20 minutes. Stability analyses take about 20 minutes too. The project doesn't include subjects with severe lower extremity injuries (eg,...

The aim of this systematic review was to synthesize the evidence for changes for proprioceptive variables consisting of movement and position sense in participants with glenohumeral musculoskeletal disorders. Five databases were searched until 13th August 2013. Methodological quality was assessed and meta-analyses were performed for active and passive joint reposition sense (AJPS and PJPS) and movement sense, determined with threshold to detection of passive motion (TTDPM). The search yielded 17 studies, four of which were classified as having high methodological quality, seven as moderate and six as low quality. For participants with post-traumatic glenohumeral instability, pooled findings indicate moderate evidence for higher TTDPM for involved shoulders compared to control groups and the contralateral uninvolved side, indicating decreased movement sense. For AJPS and PJPS there was moderate to limited evidence for significant increased errors for involved compared to uninvovled shoulders, but not when compared to the control groups. Limited evidence was found for decreased AJPS acuity for patients with chronic rotator cuff pain and for patients with unspecified shoulder pain compared to healthy controls. Movement sense is most likely to be impaired after shoulder injury involving post-traumatic instability when compared to the contralateral shoulder and to controls, while deficits for AJPS and PJPS are more likely to be evident compared to the contralateral shoulder in participants with glenohumeral musculoskeletal disorders.

abstract: Previously accomplished research examined sensory integration between upper limb proprioception and tactile sensation. The active proprioceptive-tactile relationship points towards an opportunity to examine neuromodulation effects on sensory integration with respect to proprioceptive error magnitude and direction. Efforts to improve focus and attention during upper limb proprioceptive tasks results in a decrease of proprioceptive error magnitudes and greater endpoint accuracy. Increased focus and attention can also be correlated to neurophysiological activity in the Locus Coeruleus (LC) during a variety of mental tasks. Through non-invasive trigeminal nerve stimulation, it may be possible to affect the activity of the LC and induce improvements in arousal and attention that would assist in proprioceptive estimation. The trigeminal nerve projects to the LC through the mesencephalic nucleus of the trigeminal complex, providing a pathway similar to the effects seen from vagus nerve stimulation. In this experiment, the effect of trigeminal nerve stimulation (TNS) on proprioceptive ability is evaluated by the proprioceptive estimation error magnitude and direction, while LC activation via autonomic pathways is indirectly measured using pupil diameter, pupil recovery time, and pupil velocity. TNS decreases proprioceptive error magnitude in 59% of subjects, while having no measurable impact on proprioceptive strategy. Autonomic nervous system changes were observed in 88% of subjects, with mostly parasympathetic activation and a mixed sympathetic effect. / Dissertation/Thesis / Masters Thesis Biomedical Engineering 2019

Bakgrund: Nacksmärta är en av de vanligaste muskuloskeletala åkommorna och ett av våra stora folkhälsoproblem idag. Tjugofem procent av alla patienter som söker fysioterapi representeras av nackrelaterade besvär. Det förekommer ofta en störd cervikal proprioception hos personer med nacksmärta vilket är ett viktigt sensoriskt system som definieras som vår medvetna och omedvetna uppfattning om kroppens position. Proprioceptiv träning har visat sig ha bra effekt på personer med nacksmärta. Träningen kan utformas som explicita och implicita övningar som är rörelser på medveten och omedveten nivå. VR-teknik är en rehabiliteringsform med en digital simulerad miljö som har utvärderats i flertalet studier med en god reliabilitet och validitet som bedömningsredskap och rehabiliteringsverktyg med goda resultat. Syfte: Syftet var att jämföra två olika typer av nackträning, implicit och explicit proprioceptionsträning. Metod: Studien var en kvantitativ experimentell pilotstudie som jämförde explicit och implicit proprioceptionsträning i två grupper. I studien studerades sex friska individer som fick träna två olika typer av nackträning under två veckor. Totalt utfördes sex träningstillfällen med tester innan och efter träningsperioden. I studien användes Curest VR glasögon som är ett digitalt rehabverktyg. Resultat: Den explicita gruppen fick bättre resultat på övning huvudrepositionering, följ figuren, fånga disken samt ROM än den implicita gruppen efter testtillfälle två. Konklusion: Resultaten pekar på att man blir bättre på det man tränar. Dock måste detta område fortsätta att forskas på ur ett större perspektiv för att i framtiden kunna hitta den mest effektiva träningstypen för att förbättra sensomotorisk kontroll.

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La scoliose idiopathique de l’adolescent est caractérisée par une déformation en trois dimensions de la colonne vertébrale. Les causes qui expliquent l'apparition de la scoliose demeurent encore aujourd’hui incertaines, ce qui suggère que l’étiologie de la pathologie est d’ordre multifactoriel. (Lowe et al., 2000). Il a été démontré que les patients atteints de la scoliose idiopathique voient leur contrôle postural affecté lorsque leurs informations sensorielles sont manipulées (Simoneau et al., 2006). Le but de cette étude était d’évaluer si les patients atteints de scoliose idiopathique utilisent davantage les informations vestibulaires que les informations proprioceptives pour contrôler leur équilibre. La stimulation galvanique vestibulaire a été utilisée afin d’engendrer une réponse vestibulomotrice lors de trois conditions : debout, assis stable et assis instable. De plus, la morphologie de l'appareil vestibulaire de 5 patients scoliotiques et 6 individus sains a été mesurée par la technique d’imagerie par résonnance magnétique. Les présents résultats démontrent que certains patients atteints d’une scoliose idiopathique intègrent moins efficacement les informations vestibulaires et proprioceptives du tronc et des membres inférieurs.

INTRODUCTION: La tendinopathie de la coiffe des rotateurs (TCR) entraine au quotidien des douleurs et faiblesses musculaires et une diminution du contrôle moteur à l'épaule. OBJECTIFS: Les objectifs de cette étude étaient i) d'effectuer une revue de littérature pour identifier les méthodes de quantification de la proprioception de l'épaule utilisées en laboratoire et en clinique et d’en présenter les qualités métrologiques, ii) d'évaluer l'efficacité d’un programme d’entrainement neuro-musculaire en comparant son efficacité à réduire la douleur à l’épaule et en améliorer la fonction à celle obtenue par des soins usuels de physiothérapie. MÉTHODES: i) Une revue de 5 bases de données a été conduite d’octobre 2015 à juillet 2016 pour documenter les propriétés métrologiques de protocoles d’évaluation de la proprioception à l'épaule. Les études incluses ont été évaluées à l'aide de l’outil de contrôle QualSyst et de l'échelle COSMIN à 4 points. ii) Trente-trois soldats en service actif au sein des Forces armées canadiennes ont été assignés au hasard à 1) programme standardisé supervisé d’entrainement neuromusculaire et contrôle moteur (Exp) ou à 2) soins usuels de physiothérapie (Ctl). Les variables principales étaient les symptômes, la capacité fonctionnelle et les limitations physiques évalués avec le questionnaire Disabilities of the Arm, Shoulder and Hand (DASH) et la variable secondaire était l'indice Western Ontario Rotator Cuff (WORC). Toutes les variables ont été mesurées au départ (T0) et à 6 (T6) et 12 (T12) semaines après l'intervention. La comparaison des effets des interventions a été évaluée à l'aide d’une analyse per protocole (APP), analyse intention-traitement (AIT) et avec une analyse de variance à mesures répétées à 2 voies. RÉSULTATS: i) Vingt et une études (n = 407 participants, 553 épaules) ont été retenues. Les études analysées confirment d'excellents scores méthodologiques avec l’outil QualSyst (88,1 ± 9,9%) et de bons scores avec le COSMIN pour la fidélité (71,1%) et un score de qualité modérée à faible (50%) pour la validité de critère. Les coefficients de corrélation intraclasse (CCI) pondérés pour la fidélité intraévaluateur étaient les plus élevés pour le sens du positionnement articulaire passif et la kinesthésie soit 0,92 ± 0,07 (n = 214) et 0,92 ± 0,04 (n = 74), respectivement. Le mouvement et l'outil les plus fidèles sont la rotation interne à 90 ° d'abduction (CCI = 0,88 ± 0,01 (n = 53)) et le dynamomètre (CCI = 0,92 ± 0,88 (n = 225)). Aucune étude n’a rapporté d’indices de sensibilité au changement. ii) Aucune interaction significative (p ≥ 0,101) de groupe × temps (p ≥ 0,101) n'a été démontrée. Par contre, nous avons observé un effet de temps significatif (p <0,001) pour le questionnaire DASH et l'indice WORC. CONCLUSION: Ces données préliminaires suggèrent que les deux approches proposées conduisent à des améliorations comparables. L'utilisation d'une intervention de groupe axée sur l'exercice a le potentiel d'être aussi efficace qu'une approche un à un plus exigeante en terme de temps de traitement. Ces résultats permettront de fournir aux cliniciens des lignes directrices pour la mesure de la proprioception à l'épaule et l’utilisation d’une approche novatrice de traitement en groupe pour la TCR. Mots clés : Épaule, tendinopathie, contrôle moteur, proprioception, programme d'exercices, soins en physiothérapie / INTRODUCTION: The shoulder is the most mobile joint of the body which means that it heavily relies of an important level of neuromuscular control at all times. A rotator cuff (RC) complex provides stability to the shoulder and often times falls victim to injury, which can produce functional limitations during activities of daily living and work tasks. Individuals affected by an RC tendinopathy often have neuromuscular and proprioceptive deficits. OBJECTIVES: The objectives of this study are to (i) conduct a systematic review to identify methods of quantifying shoulder proprioception in a laboratory and clinical setting and to present the associated psychometric properties. (ii) To evaluate the effectiveness of a novel neuromuscular training program for the upper extremities versus one-on-one physiotherapy care (manual therapy, range of motion exercises, strengthening) for the reduction of shoulder pain and improvement in function with soldiers affected by an RC tendinopathy. METHODS: (i) A review of five databases was conducted from conception to July 2016 to identify studies that reported at least one psychometric property of a shoulder proprioception protocol. The included studies were evaluated using the QualSyst checklist and the 4-point COSMIN scale. (ii) Thirty-three military personnel with the Canadian Armed Forces were randomly assigned to one of the following interventions: 1) Upper Extremity Neuromuscular Training Program; (2) usual physiotherapy care. The main outcomes included symptoms and functional capacity assessed using the Disability of the Arm, Shoulder, and Hand (DASH) questionnaire. A secondary outcome included the Western Ontario Rotator Cuff (WORC) Index. Outcome measures were evaluated at baseline (T0) and 6 (T6) and 12 (T12) weeks post-intervention. The effects of the interventions were evaluated using repeated 2-way variance measures (ANOVAs) for a per-protocol analysis and intention-to-treat. RESULTS: i) Twenty-one studies were included, resulting in 407 participants and 553 evaluated shoulders (n). The weighed intraclass correlation coefficients (ICC) for intra-rater reliability were highest for passive joint position sense and kinesthesia, ICC = 0.92 ± 0.07 (n = 214) and ICC = 0.92 ± 0.04 (n = 74), respectively. The most reliable direction of movement and equipment used were internal rotation at 90° abduction, ICC = 0.88 ± 0.01 (n = 53), and the dynamometer, ICC = 0.92 ± 0.88 (N = 225). ii) No significant group (p ≥ 0.1) or group × time interactions (p ≥ 0.1) were found; though a statistically significant time effect (p < 0.001) was established for the DASH questionnaire and WORC Index. Our preliminary data suggests a marginally better improvement with the control group with all outcomes over 12 weeks. CONCLUSION: The evaluation of shoulder proprioception is most reliable when using a passive protocol with an isokinetic dynamometer for internal rotation at 90° shoulder abduction. The preliminary results of our pilot RCT suggest that both groups statistically improved with a time effect, but that the usual care group further demonstrated clinically significant gains. The results of this study will provide clinicians with potential guidelines for measuring shoulder proprioception in a clinical setting, as well as an innovative approach to group therapy that is potentially less costly and equally as effective as conventional one-on-one physiotherapy. Key words (4-6) : Shoulder, tendinopathy, motor control, proprioception, exercise program, physiotherapy care