Thèse diffusée initialement dans le cadre d'un projet pilote des Presses de l'Université de Montréal/Centre d'édition numérique UdeM (1997-2008) avec l'autorisation de l'auteur.

The purpose of this study was to determine if prophylactic ankle tape and/or ankle braces improve dynamic stability in TTS measure. All subjects were healthy and had no prior history of ankle injuries. Data collection consisted of each subject performing a single leg jump-landing with ankle tape, ankle brace, combination of the two, and control (no tape or brace) conditions. Dynamic stability was assessed with time to stabilization force plate measure. Significant plane by ankle tape interaction (p=0.045) was found. No significant plane by ankle tape by ankle brace interaction (p=0.637), no significant ankle tape by ankle brace interaction (p=0.483), or plane by ankle brace interaction (p=0.697) were found. A notable finding was that subjects took longer to stabilize in the anterior/posterior direction than medial/lateral direction. In conclusion ankle tape, ankle brace, and the combination of ankle tape and ankle brace did not statistically improve dynamic stability in healthy ankles.

Title: Influence of whole body vibration training on postural stability in selected sporting population Objectives: The aim of this study is to compare the influence of whole body vibration training on the stability of the human body and assessing the possibility of using this training method to improve postural stability in selected sporting population. Methods: 15 mainly beach volleyball players (athletes) were randomly assigned into two groups. Experimental group (n 8) in addition to their own training practiced twice a week on the Power Plate, while the control group (n 7) to continue the current practice of beach volleyball. The experimental group participated in a total of twelve units during the six-week exercise intervention. We reviewed the standard deviation and average values of COP displacements in the anteroposterior, mediolateral and overall direction of the COP path. For this purpose, we used pressure platform Footscan. Results: The results indicate a clear trend to improve postural stability at the beach volleyball player after a six-week intervention, whole body vibration training. Improvement was most noticeable in tests Flamengo (standing on one leg), in which the total COP path decreased for all probands at the right lower extremity and in six of the eight probands in the left...

Autism Spectrum Disorder (ASD) is an umbrella term for disorders involving deficits in social interaction, stereotyped behaviours and communication dificulties. A growing area of research has recently focused on motor deficits in ASD, which have been noted in clinical observations and diagnostic criteria since autism was first described. However, motor deficits have traditionally carried little weight in the diagnostic procedure. Until recent changes to diagnostic criteria (Diagnostic and Statistical Manual 5th edition: DSM-5), a comorbid diagnosis of Developmental Coordination Disorder (DCD: a neurodevelopmental disorder affecting motor development) was not possible for those with ASD and motor deficits. This exclusion criterion prompted an investigation of the nature of motor deficits in ASD, questioning whether they are characteristically different from motor deficits in DCD. Previous literature suggested a possible double dissociation in the use of vision and proprioception to guide movement and perception in ASD and DCD, with a reliance on proprioception in ASD, and an over-reliance on vision in DCD. Motor deficits were first investigated by looking at high-level motor skills, and then more basic sensory processing associated with movement to investigate this possible dissociation. There was no significant difference between ASD and DCD on a standardised motor battery (Movement Assessment Battery for Children 2nd edition: MABC-2), with 70% of children with ASD showing motor difficulties within the clinical range on tasks such as timed manual dexterity tasks and balance. Similarly, children with ASD and poor motor skills were indistinguishable from children with DCD on a number of basic motor tasks manipulating visual and proprioceptive cues. These tests included spatial location matching, reaching, goal-directed movements towards proprioceptively-defined targets, and the rubber hand illusion. Children with poor motor skills with a diagnosis of either ASD or DCD seemed to either rely more heavily on visual cues, or behaved in a similar way to typically developing (TD) children. In the spatial location matching task, children with ASD and spared motor skills showed a tendency to give more weight to proprioceptive cues, however too few children with ASD and spared motor skills took part in other tasks to fully investigate cue weighting in this subgroup. Mirroring the overlap in social and motor skills in the clinical groups, a study of the relationship between perceived social and motor ability in a large sample of TD children highlighted the related nature of these developmental domains in typical development. It is concluded that motor deficits in ASD are not ASD-specific but are instead indicative of an additional diagnosis of DCD. This is supported by the recent change to diagnostic criteria.

A literatura tem mostrado que as deteriorações proprioceptivas relacionadas ao envelhecimento podem ter consequências funcionais graves na realização de tarefas sensório-motoras como postura e marcha. A avaliação do limiar de percepção cinestésica é uma forma de avaliação da acuidade proprioceptiva e representa uma tarefa sensório-motora, com envolvimento de receptores e vias periféricas bem como de níveis superiores do sistema nervoso central. O presente estudo teve como objetivo avançar no método de quantificação proprioceptiva do tornozelo em jovens e idosos e foi dividida em dois capítulos. O primeiro capítulo investigou aspectos eletrofisiológicos corticais associados à percepção cinestésica do tornozelo. O protocolo experimental consistiu de aquisição de sinais eletrencefalográficos durante a avaliação do tempo de resposta à percepção de movimento passivo de tornozelo em velocidades baixa (0,5º/s) e alta (22º/s). Foram realizadas análises de potencial relacionado a evento (ERP do inglês Event-Related Potential) e de dessincronização e sincronização relacionados a evento (ERD/ERS do inglês Event-Related Desynchronization/Synchronization) na faixa beta (14 a 37 Hz). Os resultados mostraram atrasos nos tempos de resposta à percepção cinestésica dos idosos correlacionados aos atrasos de ativação cortical. O componente inicial do ERP (N1) foi menor e mais tardio em idosos e pode indicar uma chegada de influxo aferente proprioceptivo atrasada e de menor magnitude ao córtex. Os idosos também apresentaram maior ativação cerebral (maior ERD), o que pode representar um maior esforço cognitivo para processar as informações proprioceptivas. Além disso, após finalizada a tarefa sensório-motora na condição de velocidade alta de movimentação passiva, a inibição cortical (ERS) esteve atenuada em idosos em comparação aos jovens. Na condição de velocidade baixa, ERS foi observada em idosos, mas não em jovens, o que indica diferenças em níveis corticais entre os grupos etários na preparação para o movimento seguinte. O segundo capítulo deste trabalho foi motivado por estudos que mostraram que níveis ótimos de ruído elétrico podem melhorar a detecção e transmissão de sinais neurais, melhorando o desempenho de tarefas sensório-motoras. O presente estudo investigou se a aplicação de estímulo elétrico (EE) na região posterior das pernas melhora a percepção cinestésica e o controle postural de jovens e idosos. O limiar cinestésico foi avaliado pelo tempo de resposta à percepção de movimento passivo de tornozelo na velocidade de 0,5º/s. O controle postural foi avaliado durante a manutenção da postura ereta em três condições: olhos fechados, olhos abertos com movimentação periódica ou não-periódica do cenário visual (paradigma da sala móvel). Os resultados indicaram que a aplicação de EE na perna levou a uma redução do tempo de resposta à percepção cinestésica em adultos jovens e idosos. A amplitude de oscilação corporal também foi reduzida em ambos os grupos etários com a aplicação de EE, porém somente na condição de movimentação não-periódica da sala móvel. A partir destes resultados, conclui-se que a aplicação de EE promove melhoras no desempenho sensório-motor, que estão possivelmente relacionadas com uma melhor sinalização de receptores periféricos. Estes achados podem ter implicações clínicas importantes para indivíduos idosos, cujas alterações proprioceptivas e posturais os tornam mais suscetíveis a quedas / The literature has shown that age-related proprioceptive impairments may have serious functional consequences in performing sensorimotor tasks such as posture and gait. The evaluation of threshold for kinesthetic perception is a way to assess the proprioceptive accuracy and represents a sensorimotor task involving receptors and peripheral pathways as well as processing in upper levels of the central nervous system. The present study aimed to advance the method for quantifying ankle joint proprioception in older and young adults, and was divided into two chapters. The first chapter investigated the cortical electrophysiological aspects of evaluation of the threshold for ankle kinesthetic perception. The experimental protocol consisted of acquisition of electroencephalographic signals during the evaluation of the response time to the perception of passive ankle movement at low (0.5 °/s) and high (22°/s) velocities. Event-related potentials (ERP) and event-related desynchronization and synchronization (ERD/ERS) in the beta band (14-37 Hz) were analyzed. The results showed delayed response times to the kinesthetic perception in older adults with correlated delay in cortical activation. The initial ERP component (N1) had lower amplitude and was delayed in the older group and may indicate delayed and deficient arrival of afferent inputs to the cortex. Older adults also showed larger cerebral activation (larger ERD), which may represent higher cognitive efforts to process the proprioceptive information. In addition, after completing the sensorimotor task in the high velocity condition of passive foot movement, cortical inhibition (ERS) was attenuated in older adults when compared to young adults. In the low velocity condition, ERS was observed in older but not in young adults, which indicates differences at cortical levels between age groups during the preparation for the next movement. The second chapter of this study was motivated by results from studies that have shown that optimal levels of electrical noise can enhance the detection and transmission of neural signals, thereby improving the performance of sensorimotor tasks. The present study investigated whether the application of electrical stimulation (ES) in the posterior region of the legs improves kinesthetic perception and postural control in young and elderly. The kinesthetic threshold was assessed by the response time to the perception of passive ankle movement at 0.5º/s. Postural control was assessed during the upright stance in three conditions: eyes closed and with periodic and non-periodic movement of the visual scenario by means of a moving room paradigm. The results indicated ES applied over the legs led to a reduction in the response time to kinesthetic perception in young and older adults. The body sway amplitude was also reduced in both age groups with application of ES, but only in the condition with non-periodic room movement. From these results, it is concluded that the application of ES promotes improvements in sensorimotor performance and it is possibly related to improvements of receptor signaling. These findings may have important clinical implications for older adults, whose proprioceptive and postural changes make them more susceptible to falls

Introdução: A esgrima é um esporte de agilidade, com maior incidência de lesões em membros inferiores, sendo a entorse de tornozelo a mais prevalente. A prevenção de lesões é muito importante para melhorar o desempenho e diminuir o tempo de afastamento dos atletas. Programas de treinamento proprioceptivo podem ser acrescentados aos treinamentos dos atletas, visto que além da fácil aplicação e do baixo custo, a propriocepção tem a função de estabilizar a articulação do tornozelo, prevenindo lesões. Objetivo: Verificar a influência de um programa de treinamento proprioceptivo de 12 semanas sobre o controle neurofuncional e a incidência de lesões em atletas de esgrima. Materiais e Métodos: O estudo foi um ensaio clínico randomizado, com atletas de esgrima, de 14 a 35 anos, de um clube poliesportivo de Porto Alegre/RS, e desenvolvido em seis etapas: familiarização, pré intervenção, intervenção, pós intervenção, follow up de três e seis meses. Na primeira etapa foi feita a familiarização com o teste de força e o registro das lesões ocorridas no ano anterior. Na etapa pré intervenção foi avaliada a instabilidade funcional por meio do Cumberland Ankle Instability Tools (CAIT); força muscular de inversores, eversores, dorsiflexores e plantiflexores do tornozelo através do dinamômetro isocinético; o tempo de reação dos mesmos músculos durante o Lunge Test; o controle neuromuscular durante a Star Excursion Balance Test (SEBT) e o desempenho no Drop Vertical Jump Test (DVJT). Na intervenção os atletas realizaram o treinamento proprioceptivo durante 12 semanas, três vezes por semana, com duração de 30 minutos. No pós intervenção, no follow up de três e seis meses foram realizados os mesmos testes do pré intervenção e o registro da incidência das lesões ocorridas nesses intervalos de tempo. Para análise estatística, os dados foram apresentados em média e erro padrão, submetidos ao teste de Equações de Estimativas Generalizadas com post hoc de Bonferroni. O nível de significância foi de 0,05. Resultados: Em relação à instabilidade funcional de tornozelo, o CAIT demonstrou que os atletas tinham instabilidade no momento pré intervenção e a mesma permaneceu ao longo dos quatro momentos de avaliação nos dois grupos. A força muscular de inversores e plantiflexores diminuiu significativamente, a de eversores não diferiu e a de dorsiflexores aumentou significativamente na perna da frente do grupo intervenção (GI). No grupo controle (GC) houve diminuição significativa da força de todos os músculos avaliados na perna da frente e de trás. Na perna de trás do GI apenas a força de inversores teve alterações, com diminuição significativa. A razão convencional de eversores/inversores e dorsiflexores/plantiflexores aumentou significativamente na perna da frente do GI e não diferiu na perna de trás desse grupo, enquanto que no GC houve diminuição significativa da razão de dorsiflexores/plantiflexores na perna da frente. A razão funcional de eversores/inversores aumentou significativamente na perna da frente dos dois grupos. A razão funcional de eversores/inversores da perna de trás, assim como de dorsiflexores/plantiflexores das duas pernas, não diferiu nos dois grupos. O tempo de reação do tibial anterior não diferiu em nenhum dos grupos e em nenhuma das pernas, o do tibial posterior aumentou na perna da frente do GI e do fibular longo e do gastrocnêmio lateral diminuiu significativamente nos dois grupos. A distância alcançada na SEBT aumentou significativamente em todas as oito direções avaliadas nas duas pernas do GI e em algumas direções do GC. O desempenho nos saltos diminui significativamente no DVJT de 40cm e 50cm no GI e no DVJT de 30cm e 50cm no GC. A incidência de lesões diminuiu no GI do momento pré para o pós e aumentou no GC nesse mesmo período. Conclusão: O programa de treinamento proprioceptivo foi capaz de melhorar a força muscular dos dorsiflexores e o controle neuromuscular dinâmico, além de diminuir a incidência de lesões em atletas da esgrima, sem interferências nas demais variáveis. / Introduction: Fencing is a sport of agility, with a higher incidence of lower limb injuries, with ankle sprain being the most prevalent. Injury prevention is very important to improve performance and decrease the withdrawal time of athletes. Proprioceptive training programs can be added to the training of athletes, since in addition to easy application and low cost, proprioception has the function of stabilizing the ankle joint, preventing injuries. Objective: To verify the influence of a 12-week proprioceptive training program on neurofunctional control and the incidence of injuries in fencing athletes. Material and Methods: The study was a randomized clinical trial of 14 to 35 year old fencing athletes from a multi-sport club in Porto Alegre, Brazil, and developed in six stages: familiarization, pre intervention, intervention, post intervention, follow up three and six months. In the first stage the familiarization with the force test and the registry of the injuries occurred in the previous year was made. In the pre intervention stage, functional instability was evaluated through the Cumberland Ankle Instability Tools (CAIT), the muscular strength of the ankle inverters, eversors, dorsiflexors and plantiflexors through the isokinetic dynamometer was evaluated; the reaction time of the same muscles during the Lunge Test; the neuromuscular control during the Star Excursion Balance Test (SEBT) and the performance in the Drop Vertical Jump Test (DVJT). In the intervention, the athletes performed the proprioceptive training for 12 weeks, three times a week, lasting 30 minutes. In the post-intervention, at the follow up of three and six months, the same pre-intervention tests were performed and the incidence of lesions occurred at these time intervals. For statistical analysis, the data were presented in mean and standard error, submitted to the Generalized Estimates Equations test with Bonferroni post hoc. The level of significance was 0,05. Results: Regarding functional ankle instability, the CAIT demonstrated that the athletes had instability at the pre-intervention time and it remained throughout the four evaluation moments in both groups. The muscle strength of inverters and plantiflexors decreased significantly, that of eversors did not differ and that of dorsiflexors increased significantly in the front leg of the intervention group (IG). In the control group (CG) there was a significant decrease in the strength of all the muscles evaluated in the front and back legs. In the back leg of the IG only the inverter force had changes, with significant decrease. The conventional ratio of eversor/inverters and dorsiflexors/plantiflexors increased significantly in the front leg of the IG and did not differ in the hind leg of this group, whereas in CG there was a significant decrease in the ratio of dorsiflexors/plantiflexors in the front leg. The functional ratio of eversor/inverters increased significantly in the front leg of the two groups. The functional ratio of rear leg eversor/inverters, as well as dorsiflexors/plantiflexors of the two legs, did not differ in the two groups. The reaction time of the anterior tibial did not differ in any of the groups, nor in any of the legs, that of the posterior tibial increased in the front leg of the intervention group and the long fibular and lateral gastrocnemius decreased significantly in both groups The distance reached in the SEBT increased significantly in all eight directions evaluated in the two legs of the IG and in some directions of the control group. The performance in the jumps decreases significantly in the DVJT of 40cm and 50cm in the IG and in the DVJT of 30cm and 50cm in the CG. The incidence of lesions decreased in the IG from the pre-post to the post and increased in the CG in the same period. Conclusion: The proprioceptive training program was able to improve the muscular strength of the dorsiflexors and the dynamic neuromuscular control, besides reducing the incidence of injuries in fencing athletes, without interferences in the other variables.

Made available in DSpace on 2014-06-11T19:30:53Z (GMT). No. of bitstreams: 0 Previous issue date: 2007-03-16Bitstream added on 2014-06-13T20:40:41Z : No. of bitstreams: 1 bonfim_tr_dr_rcla.pdf: 758193 bytes, checksum: 4e539179f9c143bb71a697cea610fe9a (MD5) / Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) / Após a lesão do Ligamento Cruzado Anterior (LCA), a percepção de movimento e o controle postural estão comprometidos, possivelmente pela redução de informação sensorial da perna lesada. Assim, o objetivo desta tese foi investigar o efeito do uso de informação sensorial adicional na propriocepção e no controle postural de indivíduos com lesão do LCA e de indivíduos com joelhos sadios. Foi realizada uma breve revisão teórica e dois conjuntos de análises em um mesmo estudo experimental. O primeiro conjunto de análises investigou o efeito da adição de informação sensorial no limiar para detecção de movimento passivo da articulação do joelho e no controle postural de 28 indivíduos com lesão unilateral do LCA e de 28 indivíduos com joelhos sadios. O limiar para detecção de movimento passivo (LDMP) foi avaliado nas posições de 15 e 45 graus, para as direções de flexão e extensão. O controle postural foi investigado por meio da área de deslocamento, amplitude e velocidade média de oscilação e freqüência mediana de oscilação do centro de pressão (CP). As condições de informação sensorial foram: informação normal, bandagem infra-patelar, faixa infra-patelar e toque suave em uma barra estacionária (força inferior a 1 Newton). Os resultados demonstraram que o LDMP é maior em indivíduos com lesão do LCA, no entanto, há redução do mesmo com a utilização de informação sensorial adicional. A área, a amplitude e a velocidade média de oscilação do CP são maiores após a lesão do LCA e há uma redução com o uso de informação sensorial adicional. Indivíduos com joelhos sadios apresentam uma redução da oscilação corporal apenas na condição de toque suave. / After Anterior Cruciate Ligament (ACL) lesion, perception of movement and postural control are compromised, possibly by reduction of the sensorial information from the injured leg. Therefore, the purpose of this thesis was to examine the effect of the use of additional sensorial information in the proprioception and in the postural control of individuals with ACL lesion and individuals with healthy knees. A short theoretical revision and two groups of specific in a same experimental study were realized. The first group of analyses investigated the effect of the addition of sensorial information in the threshold to detection of passive knee motion and in the control postural of 28 individuals with ACL unilateral lesion and 28 individuals with healthy knees. The threshold to detection of passive motion (TDPM) was evaluated in the positions of 15 and 45 degrees, for flexion and extension directions. Postural control was investigated through the displacement area, mean sway amplitude, mean sway velocity and medium frequency of the center of pressure (CP). The conditions of sensorial information were: normal information, infra-patellar adhesive tape, infra-patelar band and light touch in a stationary bar (applied force below 1 Newton). The results demonstrated that TDPM is larger in individuals with ACL lesion; however, TDPM is reduced with the use of additional sensorial information. The area, mean sway amplitude and mean sway velocity of the CP are larger after ACL lesion and there is a reduction with the use of additional sensorial information. Individuals with healthy knees presented a reduction of the body oscillation only in the condition of light touch.

abstract: A history of trauma can affect a child’s capacity to express emotions due to the neurological footprints left from neglect and abuse. Oftentimes, children do not have a caregiver as a protector which leaves them vulnerable to harm. In response, children use emotional survival strategies of either flight or fight to adapt to their stressful environment. Occupational Therapy Practitioners (OTP) are positioned to address social and emotional development; however, they often feel ill equipped to address the complexity of trauma and its impact on emotions. OTPs need to look at each sensory system from a nurturing/grounding perspective using movement-based strategies as inroads to address the child’s emotional capacity. A sensory integration intervention, Proprioceptive Activities to Lower Stress (PALS), was developed to study the effect on a six-year-old boy’s expressions of emotions using a single subject design. Three emotions were measured using a facial analysis system, Noldus FaceReader™. The emotions were happiness, sadness, and neutral. Neutral is defined as the level of emotional detachment. Results indicate a statistically significant improvement in the expressions of happiness and sad post the PALS program. / Dissertation/Thesis / Doctoral Dissertation Leadership and Innovation 2019

Abstract not available

Dans le champ des neurosciences comportementales, une interrogation demeure quant à la contribution des informations visuelles et proprioceptives permettant de localiser la main et la cible pendant la réalisation d'un mouvement de la main vers une cible visuelle. Nous avons développé une méthode originale pour investiguer la thématique du contrôle en ligne du mouvement. Dans chacune des études réalisées, des participants adultes essayaient d'atteindre le plus précisément possible des cibles visuelles présentées dans l'obscurité. Des modifications de la position de la cible mais également de la position vue de la main étaient réalisées de façon aléatoire et nous avons analysé comment cela affectait le comportement moteur des sujets. Pour que l'influence de processus cognitifs sur le contrôle en ligne du mouvement soit aussi similaire que possible dans les conditions avec ou sans perturbation, nous avons choisi de produire ces perturbations sans que les sujets ne puissent les percevoir dans le sens où ils n'ont jamais été capables d'en rendre compte verbalement. L'étude 1 a montré que l'information visuelle relative à la position de la cible était prise en compte de manière plus importante et plus rapide par rapport à l'information visuelle relative à la position de la main, pour le contrôle en temps réel des mouvements rapides. Toutefois, la principale question dégagée de cette étude a concerné l'utilisation limitée du feedback visuel de la main, une observation qui semblait en opposition avec nombre d'études ayant montré le rôle essentiel de ce type d'information dans le contrôle de mouvements d'atteinte manuelle. En fait, une analyse approfondie de la littérature a laissé suggérer que la nature de la tâche, où l'amplitude du mouvement devait être contrôlée, pourrait avoir limité le traitement optimal de l'information visuelle. L'étude 2 avait pour but d'examiner l'utilisation du feedback visuel de la main dans le contrôle de mouvements d'atteinte manuelle lorsque seule la composante directionnelle du mouvement est à contrôler. L'étude 2 a permis de mettre en évidence la capacité d'intégration rapide et précise du système nerveux central des informations visuelles et proprioceptives sur la position de la main. L'information visuelle a en effet été utilisée de manière consistante et significative, un résultat différant singulièrement de celui obtenu dans l'étude 1 où essentiellement l'amplitude du mouvement était à contrôler. Dès lors, il nous a paru intéressant d'étudier une tâche où des modifications de l'information visuelle devaient résulter en des modifications de l'amplitude et de la direction du mouvement. La question sous-jacente était de savoir si le contrôle des deux composantes serait identique aux deux expériences précédentes ou si il y aurait un effet de type interaction au niveau du contrôle. L'étude 3 a notamment permis de démontrer que le contrôle directionnel de mouvements rapides sur la base d'informations visuelles de la main est limité par le contrôle de l'amplitude (que l'on peut alors légitimement définir comme une contrainte). En fait, le fait de contrôler l'amplitude (et donc le freinage du mouvement) semble limiter plus généralement le contrôle en ligne du mouvement sur la base des informations de localisation de la main. A ce stade, nous avions donc démontré la contribution des informations visuelles de localisation de la cible et de la main, ainsi que des informations proprioceptives au contrôle courant des mouvements d'atteinte manuelle. Nos expériences ont donc permis de démontrer les rôles essentiels des informations proprioceptives et visuelles (relatives à la position de la main et de la cible). Afin d'étudier le caractère indispensable de ces boucles de rétroaction, nous avons eu l'opportunité de travailler avec une patiente proprioceptivement désafférentée. L'étude 4 nous a permis de montrer qu'un contrôle du geste en cours d'exécution était possible malgré l'absence de boucles de rétroaction sensorielles périphériques sur la localisation de la main et de la cible. Nous proposons donc un modèle du contrôle en ligne du mouvement basé sur une utilisation optimale des mécanismes proactifs et rétroactifs, ainsi que sur la continuité et la rapidité du processus de traitement de l'information.