The thesis deals with the possibility to influence the values of the lung function in patiens with chronic obstructive pulmonary disease (COPD) after exercise carried out according to the Methodology of sensorimotor training. The thesis contains a summary of theoretical knowledge about the pathophysiologic expresion of COPD, including their consequences not only for the respiratory system, but musculoskeletal system as well. Furthermore the thesis includes the information about the Methodology of sensorimotor training, that was used to influence the posture correction in our research. Methods: The spirometric examination of flow-volume curves monitor the changes prior to and after the exercise according to sensorimotor training in patiens with COPD (mean age 60, 733 ± 11,817). Results: The using of sensorimotor training can provide correction of the position of the whole body, of the chest, and change a chest mobility and in total to set up conditions for more economical muscle activation. This enable the changes in the values of the lung functions in the patiens with COPD, that we measured. Not all changes showed statistically significant change. Conclusion: Using sensorimotor training have an objective effect on the values of the lung function in patiens with COPD.

Tendinopathien der Achilles- oder Patellarsehne sind häufig in Sportarten mit zahlreichen repetitiven Belastungen im Dehnungs-Verkürzungs-Zyklus der unteren Extremität zu finden. Sowohl eine möglicherweise alterierte belastungsspezifische neuromuskuläre Antwort (NMA), als auch funktional begründete Therapiemaßnahmen mit möglichen positiven Effekten sind aktuell ungeklärt. Ziel der Arbeit war deshalb die Untersuchung der belastungsspezifischen neuromuskulären Antwort bei Athleten mit Tendinopathie der Achilles- oder Patellarsehne im Vergleich zu beschwerdefreien Athleten. Zusätzlich sollten mögliche funktionale und therapeutische Effekte eines sensomotorischen Trainings im randomisierten, kontrollierten und prospektiven Studiendesign überprüft werden. 51 Sportler mit unilateraler Tendinopathie (Achilles-/Patellarsehne n = 35/16) und 33 gesunde Sportler wurden zur Beurteilung der belastungsspezifischen neuromuskulären Antwort eingeschlossen. Zur Klärung der Effekte eines sensomotorischen Trainings im Längsschnitt konnten 26 Sportler mit Tendinopathie randomisiert zu einer Kontrollgruppe (n = 14) und einer Therapiegruppe mit sensomotorischem Training (n = 12) zugeordnet werden. Nach einer ersten biomechanischen Messung M1 (Belastungssituationen: Lauf-, Stabilisations-, Kraftbelastung) und der Erhebung der subjektiven Schmerzsymptomatik folgte eine 8-wöchige Therapiephase mit einer abschließenden Re-Test-Messung M2 identisch zu M1. Das sensomotorische Training war auf die gesamte untere Extremität ausgerichtet und wurde nach Einweisung regelmäßig kontrolliert. Die Erfassung der NMA erfolgte über die Quantifizierung der muskulären Aktivität (EMG). Zusätzlich wurde die Kinetik (z.B. Maximalkraft) belastungsspezifisch erfasst. Eine reduzierte NMA konnte für die Sportler mit Tendinopathie über veränderte EMG-Zeit- und Amplitudenmessgrößen, eine reduzierte aktive Stabilisationsfähigkeit und Maximalkraft (p < 0,05) nachgewiesen werden. In Abhängigkeit der Lokalisation (Achilles-/Patellarsehen) bzw. der Seite (Beschwerdeseite/gesunde Seite) ergaben sich keine relevanten Differenzen. Das sensomotorische Training zeigte eine Optimierung der NMA (z.B. erhöhte Maximalkraft) bei Tendinopathie der Achilles- oder Patellarsehne. Die Überprüfung der Beschwerdesymptomatik wies in allen Schmerz-Scores nach der Therapie reduzierte Werte und damit einen positiven therapeutischen Effekt gegenüber der Kontrollgruppe auf. Zusammenfassend kann eine systematisch reduzierte NMA bei Lauf-, Stabilisations- und Kraftbelastung der Sportler mit Tendinopathie nachgewiesen werden. Das sensomotorische Training ist funktional und therapeutisch als effiziente Therapiemaßnahme zu erachten. / Tendinopathies of the achilles- or patellartendon are common overuse unjuries in sports including high numbers of repetitive stretch-shortening-cycles of the lower limb. Possible alterations of the neuromuscular response (NMR) to physical stress and functionally justified therapies with potential positive effects are currently unknown. The aim of the study was therefore the analysis of the neuromuscular response in situations with physical stress in athletes with tendinopathie of the achilles or patellartendon compared to symptom free athletes. In addition, possible functional and therapeutic effects of a sensorimotor training were studied in a prospective, randomized and controlled study. 51 athletes with unilateral tendinopathy (achilles-/patellartendon n = 35/16) and 33 healthy athletes were included to assess the stress related neuromuscular response (NMR). To clarify the effects of a sensorimotor training 26 athletes with tendinopathy were randomized to a control group (n = 14) and a therapy group with sensorimotor training (n = 12). After initial biomechanical measurements M1 (situations: running, active postural stability and maximum strength test) and the collection of subjective complaints (pain) an 8-week treatment phase followed with a final re-test M2 measure identical to M1. The sensorimotor training was arranged for the entire lower extremity, and was checked after an initial briefing on a regular basis. The assessment of the NMR was quantified by muscle activity (EMG). In addition, the kinetics (e.g. maximum force) was acquired in the stabilization and maximum strength test. A reduced NMR could be proven for athletes with tendinopathy with changed EMG time and amplitude measurements, a reduced active postural stabilization ability and reduced maximum strength (p <0.05). No relevant differences could be observed in comparing localization (achilles-/patellartendon) and side (leg with complains/healthy leg). The sensorimotor training showed an optimization of NMR (e.g. increased maximum strength) for patient with tendinopathy of the achilles- or patellartendon. The examination of the complaints showed reduced values in all pain scores after therapy. The treatment had therefore positive therapeutic effects compared to the control group. In summary, a systematically reduced NMR in running, stabilization and strength tests are evident for athletes with tendinopathy. The sensorimotor training can be considered as an efficient treatment with functional and therapeutic effects.

Submitted by Giovana Duarte Eltz (giovanade@gmail.com) on 2018-11-05T18:14:49Z No. of bitstreams: 1 TESE_COMPLETA_GIOVANA_ELTZ.pdf: 4010107 bytes, checksum: 82dcbe682e9275743432a9a86507b6bd (MD5) / Approved for entry into archive by Ana Paula Santulo Custódio de Medeiros null (asantulo@rc.unesp.br) on 2018-11-06T12:34:58Z (GMT) No. of bitstreams: 1 eltz_gd_dr_rcla.pdf: 3976412 bytes, checksum: 7aa89cfe68372eae2fdd7318c0d3e25f (MD5) / Made available in DSpace on 2018-11-06T12:34:58Z (GMT). No. of bitstreams: 1 eltz_gd_dr_rcla.pdf: 3976412 bytes, checksum: 7aa89cfe68372eae2fdd7318c0d3e25f (MD5) Previous issue date: 2018-09-05 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / O equilíbrio é um pré-requisito importante para o aprendizado de habilidades motoras complexas e estão relacionadas ao esporte, desde a juventude até a idade adulta. O desempenho do equilíbrio vem sendo associado a melhora do desempenho atlético (ou seja, saltos verticais, sprints, tarefas de mudança de direção) e até mesmo está sendo considerado uma condição importante para o atleta tornar-se de alto nível. Atualmente equipes e atletas estão utilizando o treino de equilíbrio como uma modalidade de exercício para melhorar o equilíbrio, prevenir lesões nas extremidades inferiores, reabilitar a propriocepção e função neuromuscular. Este treinamento, tem como objetivo gerar instabilidade ao atleta e com isso gerar melhora do controle postural, propriocepção e alguns casos força. A melhora controle postural se dá através dos mecanismos neuronais, envolvendo redes espinhais e supraespinhais. No nível da coluna vertebral, o treino de equilíbrio inibe a excitabilidade reflexa espinhal devido a um aumento na inibição pré-sináptica. Melhorias no desempenho do equilíbrio estão associadas a redução da excitabilidade córticoespinal e cortical (nível supraespinhal), gerando regulações no reflexo. Além disso, adaptações favoráveis após treinamento de equilíbrio podem estar associadas as mudanças estruturais na massa cinzenta e substância branca no lobo pré-frontal em indivíduos jovens saudáveis. Portanto, mudanças geradas no Sistema Nervoso Central (SNC) podem contribuir na melhora do desempenho do equilíbrio e nos efeitos que tendem a prevenir as lesões. Apesar do treinamento equilíbrio ser uma ferramenta efetiva para a melhoria do controle postural e variáveis neuromusculares, ainda há contradição na literatura em relação aos seus efeitos no desempenho de atletas e pouco se sabe sobre o efeito imediato deste treinamento. Preparadores físicos e fisioterapeutas devem considerar que os indivíduos submetidos a treinos de equilíbrio possam apresentar déficit imediato. O objetivo desta pesquisa é determinar quais parâmetros biomecânicos são influenciados após o treinamento equilíbrio em atletas de forma imediata e crônica. As coletas foram realizadas em 45 participantes do sexo feminino e 15 do masculino com idade entre 18 e 35 anos, sendo que para o experimento 1 e 2 foram avaliadas trinta jogadoras de basquete, no experimento 3 atletas de diversas modalidades, quinze mulheres e quinze homens. No experimento 1 e 3 foram realizadas avaliações imediatamente após o treinamento de equilíbrio, 15 minutos e 30 minutos. No experimento 1 foram avaliadas as variáveis de equilíbrio (área, comprimento e velocidade do centro de pressão - COP) e do salto contramovimento (altura e força de reação do solo na aterrissagem), já no experimento 3 foram realizados testes isométricos e isocinético para verificação do torque e com eletromiografia nos músculos reto femoral, vasto lateral e vasto medial para cálculos da eficiência neuromuscular. No experimento 2 foi realizado treinamento equilíbrio com jogadoras de basquete por oito semanas. Foram divididas em dois grupos (controle e treinamento), realizaram avaliações pré e pós treinamento. As avaliações realizadas foram senso de posição ativa, cinestesia, teste isométrico e teste isocinético de joelho dominante, equilíbrio unipodal e salto contramovimento. Após a verificação da normalidade (ShapiroWilk) e homogeneidade (Levene), foi utilizado o teste T independente para comparar as variáveis dependentes entre grupos. Para verificar o efeito do treinamento de equilíbrio, foi aplicada a análise de variância (ANOVA) two-way. Na sequência utilizou-se a ANOVA one way, com correção de Bonferroni para análises par a par quando encontradas interações ou quando encontrados somente efeitos principais. Para todas as variáveis foram adotados o nível de significância de α < 0.05. Após 8 semanas de treino, o grupo treinamento melhorou o desempenho do salto, do equilíbrio olhos fechado e olhos aberto membro não dominante, do senso de posição, torque isométrico e isocinético, mas não apresentou melhora no equilíbrio olhos abertos membro dominante e cinestesia. Já no efeito imediato apenas a altura do salto contramovimento não apresentou déficit imediatamente pós o treino de equilíbrio. As demais variáveis, força de reação do solo, equilíbrio unipodal, torque isométrico, torque isocinético e eficiência neuromuscular apresentaram déficit imediatos ao treino e algumas delas levando não retornaram ao valor basal após 30 minutos de treino. / Balance is an important prerequisite for learning complex, life-related motor skills. Balance performance has been associated with improved athletic performance (ie, vertical jumps, sprints, change-of-direction tasks) and is even considered to be an important condition for the athlete to become a high-level athlete. Currently teams and athletes are using balance training as an exercise modality to improve balance, prevent injury to the lower extremities, rehabilitate proprioception and neuromuscular function. This training aims to generate instability to the athlete and with that improves athletes’ postural control through neuronal mechanisms, involving spinal and supraspinal networks. At the spinal level, balance training apears to inhibit spinal reflex excitability due to an increase in presynaptic inhibition. Improvements in balance performance can be associated with substantially reduce corticospinal and cortical excitability so that the traininginduced reflex down-regulation is associated with improvements in balance performance (supraspinal level). In addition, favorable adaptations after balance training may be associated with structural changes in gray matter and white matter in the prefrontal lobe in healthy young subjects. Therefore, changes generated in the Central Nervous System (CNS) may contribute to improved balance performance and to effects that tend to prevent injury. Although balance training is an effective tool for the improvement of postural control and neuromuscular variables, there is still contradiction in the literature regarding its effects on the performance of athletes and little is known about the immediate effect of this training. Physical trainers and physiotherapists should consider that individuals submitted to balance training may present immediate deficit. The aim of this research is to determine which biomechanical parameters are influenced after the balance training in athletes immediately and chronically. The samples were collected in 45 female participants and 15 male participants aged 18 to 35 years. For the experiment 1 and 2, thirty basketball players were evaluated, in the experiment 3 athletes of various modalities, fifteen women and fifteen men. In experiments 1 and 3, evaluations were performed immediately after the balance training, 15 minutes and 30 minutes. In the experiment 1, were evaluated the variables of balance and countermovement jump, and in the experiment 3, was performed isometric and isokinetic tests with electromyography in the rectus femoris, vastus lateralis and vastus medialis muscles. In experiment 2, balance training was performed with basketball players for eight weeks. They were divided into two groups (control and training), performed pre and post training assessments. The evaluations performed were a sense of active position, kinesthesia, isometric test and isokinetic test of dominant knee, unipodal balance and countermovement jump. After verification of normality (Shapiro-Wilk) and homogeneity (Levene), the independent T-test was used to compare the dependent variables between groups. To verify the effect of the balance training, the ANOVA two-way was applied. An ANOVA one way, with Bonferroni correction, was used for parity analyzes when interactions were found or when only main effects were found. For all variables, the level of significance of α <0.05 was adopted. After 8 weeks of training, the training group improved the performance of the jump, the closed eyes balance and open eyes non-dominant limb, the sense of position, isometric and isokinetic torque, but did not show improvement in the open eyes limb dominant balance and kinesthesia. Already in the immediate effect only the height of the countermovement jump did not present deficit immediately after the balance training. The other variables, ground reaction force, unipodal balance, isometric torque, isokinetic torque and neuromuscular efficiency presented immediate training deficit, and some of them did not return to baseline after 30 minutes of training. / CAPES: 001

We followed the immediate effect of sensorimotor training on postural stability in patients with spinocerebellar ataxia (SCA). We have tried to explain the possible mechanisms of adaptation to change COP, motor learning and neuroplasticity in the field of neurodegenerative changes in the cerebellum. Research Methods: A total of 10 patients with spinocerebellar ataxia (6 men, 4 women) aged 34-71 years, with an average disease duration of 11.6 years participated in the measurement of postural stability. First, we measured the patients with SCA before and after a 15-minute sensorimotor-training exercise, then this group underwent another day of the same measurement without sensorimotor training. As a second control group of 10 healthy subjects served a similar age, who also underwent sensorimotor training. Then we compared the results of posturographic measurement. Results: In the group of SCA patients, sensorimotor training was found significantly lower values in the monitored parameters LENGTH (t stat = 3,537731 > t krit = 2,262157), VELOCITY (t stat = 3,537731 > t krit = 2,262157) and energy to sustain COP (t stat = 2,715085 > t krit = 2,262157), measured on a foam pad with eyes closed. Measurement without making sensorimotor training produced no significant improvement in the results of monitored...

Title: Evaluation of the effect of exercise according to the Propriofoot concept and the methodology of Sensorimotor Training by Janda and Vávrová on foot pressure distribution Objectives: In this thesis the following three goals were set: First, to find out if and how does the percentual foot pressure distribution between the left and right foot in standing change after a four-week long exercise according to either the methodology of Sensorimotor training by Janda and Vávrová or the Propriofoot concept. Second, if and how will the segmental foot load change. Third, if the prospective changes of foot load will agree or differ between the two groups. Methods: A pilot study for quantitative research using experimental scientific method was conducted, with two groups consisting of ten members each, aged thirty to fifty and diagnosed with flat foot. At the beginning, all probands underwent diagnostic measurement using the "Plantograf V10" device. Then they attended a four-week long individual therapy with an exercise plan created according to one of the two methods in consideration. At the end the probands were again measured by the same device. Entrance and control measurements obtained for each participant and both groups were evaluated, compared and statistically analyzed. Results: Analysis of the...

Title: The effect of one-off so called sensorimotor serie exercise on postural stability measured on Neurocom SMART Equitest Aim: The goal of this thesis is to evaluate the effect of one-off so-called sensorimotor serie exercise on postural stability on a healthy young human measured by computerized dynamic posturography (CDP). Methods: This experimental study is using a cross-over design, it means that participants got the intervention in randomized order. 20 healthy young subjects participated in the experiment, 12 women and 8 men aged 20 to 28 years (23,55± 1,63). The group of men and women was randomly divided into two groups. Group E1 was measured by Neurocom SMART Equitest using three testing protocols (SOT, MCT, LOS), went through the one-off so called sensorimotor serie, and was measured again immediately afterwards (almost 30 minutes after the first measurement) at the first appointment. In 1 week ± 1 day (wash-out period) participants from the group E1 were only measured without getting any intervention and after 30 minutes break measured again. Group E2 got the intervention in opposite order. Measured data were processed using the Neurocom Balance Manager Software. In the statistical analysis was used one-sample t-test respectively two-sample t-test (Welch's version) as a comparison...