Estudos pregressos têm investigado causas e fatores de risco para quedas e incapacidade funcional em idosos. Porém, no que se refere a fatores biomecânicos envolvidos no desempenho funcional e controle postural, a contribuição dos grupos musculares proximais de quadril e de tronco ainda recebe pouca atenção. Assim, o objetivo deste estudo foi verificar a associação entre a função muscular dos abdutores e adutores do quadril e dos extensores e flexores do tronco com o desempenho do equilíbrio semi-estático e dinâmico e da funcionalidade de idosos independentes que vivem na comunidade. Métodos: oitenta e um idosos de ambos os sexos foram submetidos à avaliação do equilíbrio e da funcionalidade por meio dos testes: (1) marcha tandem sobre a plataforma de força Balance Master (Neurocom International Inc., Clackamas, OR) para obtenção das variáveis velocidade da marcha tandem e velocidade de oscilação corporal ao final da marcha tandem; e (2) testes clínicos de apoio unipodal e Timed Up and Go (TUG). Também foram submetidos à avaliação da função muscular em dinamômetro isocinético (Biodex System 4 Pro, Nova York, EUA) por meio de 3 contrações isométricas máximas de abdução e adução do quadril e flexão e extensão do tronco para obtenção das variáveis pico de torque (PT) e taxa de desenvolvimento de força (TDF) proporcionais ao peso corporal. Após aplicação do teste de normalidade de Shapiro-Wilk, foi realizado teste de correlação de Pearson (dados com distribuição normal) e de Spearman (dados com distribuição não-normal). Para aquelas variáveis com coeficiente de correlação significativo, foi aplicado teste de regressão linear para quantificar o índice de determinação (r2) da função muscular do quadril e tronco no equilíbrio e funcionalidade de idosos. Foi adotado nível de significância de 5% (p < 0,05). Resultados: houve correlação com índice de determinação significativo do PT dos grupos musculares do quadril e do tronco sobre o desempenho dos testes de equilíbrio e funcionalidade. Em relação à TDF, foi encontrada correlação com índice de determinação significativo da TDF de abdução de quadril e de extensão de tronco sobre a velocidade de oscilação ao final da marcha tandem e sobre o TUG e também da TDF de extensão de tronco sobre o apoio unipodal. Conclusões: esses 10 achados podem ser clinicamente relevantes considerando que (1) diferentes parâmetros da função muscular (como PT e TDF) apresentam diferentes estratégias de intervenção para seu aprimoramento e que (2) problemas de equilíbrio e/ou de funcionalidade em idosos podem estar associados com comprometimentos da TDF e do PT da musculatura proximal, os quais são parâmetros passíveis de intervenção. / Previous studies have investigated causes and risk factors for falls and functional disability in the elderly. However, regarding biomechanical factors involved in the functional performance and postural control, the contribution of the proximal muscle groups of the hip and trunk still receives little attention. The objective of this study was to assess the association between muscle function of hip abductors and adductors and trunk flexors and extensors muscles with the performance of static and dynamic balance and functionality of community-dwelling older adults. Methods: eighty-one elderly of both sexes underwent assessment of balance and functionality through: (1) tandem gait test on the Balance Master force platform (Neurocom International Inc., Clackamas, OR) to obtain the variable tandem gait speed and body sway velocity in the end of tandem gait; and (2) clinical tests of single-leg stance and Timed Up and Go (TUG). The participants also underwent assessment of muscle function in isokinetic dynamometer (Biodex System 4 Pro, New York, USA) through 3 maximal isometric contractions of abduction and adduction of the hip and flexion and extension of the trunk to obtain the variables peak torque (PT) and rate of force development (RFD) in proportion to body weight. The Shapiro-Wilk normality test was performed and then, Pearson correlation test (data with normal distribution) and Spearman (data with non-normal distribution) were applied. Linear regression test was applied to quantify the determination index (r2) of muscle function of the hip and trunk in balance and functionality of the elderly for those variables with significant correlation coefficient. It was adopted a significance level of 5% (p < 0.05). Results: there was correlation with a significant determination index of PT of muscle groups of the hip and trunk in the performance of balance and functionality tests. Regarding the RFD, it was found correlation with significant determination index of RFD of the hip abduction and trunk extension in the body sway velocity in the end of tandem gait and TUG; and of RFD of the trunk extension in single-leg stance. Conclusions: These findings may be clinically relevant considering that (1) different parameters of muscle function (such as PT and RDF) have different intervention strategies for their improvement and (2) problems of balance and / or functionality in the elderly may be 12 associated with impairments of RFD and PT of proximal muscles, which are parameters that can be treated.

Estudos pregressos têm investigado causas e fatores de risco para quedas e incapacidade funcional em idosos. Porém, no que se refere a fatores biomecânicos envolvidos no desempenho funcional e controle postural, a contribuição dos grupos musculares proximais de quadril e de tronco ainda recebe pouca atenção. Assim, o objetivo deste estudo foi verificar a associação entre a função muscular dos abdutores e adutores do quadril e dos extensores e flexores do tronco com o desempenho do equilíbrio semi-estático e dinâmico e da funcionalidade de idosos independentes que vivem na comunidade. Métodos: oitenta e um idosos de ambos os sexos foram submetidos à avaliação do equilíbrio e da funcionalidade por meio dos testes: (1) marcha tandem sobre a plataforma de força Balance Master (Neurocom International Inc., Clackamas, OR) para obtenção das variáveis velocidade da marcha tandem e velocidade de oscilação corporal ao final da marcha tandem; e (2) testes clínicos de apoio unipodal e Timed Up and Go (TUG). Também foram submetidos à avaliação da função muscular em dinamômetro isocinético (Biodex System 4 Pro, Nova York, EUA) por meio de 3 contrações isométricas máximas de abdução e adução do quadril e flexão e extensão do tronco para obtenção das variáveis pico de torque (PT) e taxa de desenvolvimento de força (TDF) proporcionais ao peso corporal. Após aplicação do teste de normalidade de Shapiro-Wilk, foi realizado teste de correlação de Pearson (dados com distribuição normal) e de Spearman (dados com distribuição não-normal). Para aquelas variáveis com coeficiente de correlação significativo, foi aplicado teste de regressão linear para quantificar o índice de determinação (r2) da função muscular do quadril e tronco no equilíbrio e funcionalidade de idosos. Foi adotado nível de significância de 5% (p < 0,05). Resultados: houve correlação com índice de determinação significativo do PT dos grupos musculares do quadril e do tronco sobre o desempenho dos testes de equilíbrio e funcionalidade. Em relação à TDF, foi encontrada correlação com índice de determinação significativo da TDF de abdução de quadril e de extensão de tronco sobre a velocidade de oscilação ao final da marcha tandem e sobre o TUG e também da TDF de extensão de tronco sobre o apoio unipodal. Conclusões: esses 10 achados podem ser clinicamente relevantes considerando que (1) diferentes parâmetros da função muscular (como PT e TDF) apresentam diferentes estratégias de intervenção para seu aprimoramento e que (2) problemas de equilíbrio e/ou de funcionalidade em idosos podem estar associados com comprometimentos da TDF e do PT da musculatura proximal, os quais são parâmetros passíveis de intervenção. / Previous studies have investigated causes and risk factors for falls and functional disability in the elderly. However, regarding biomechanical factors involved in the functional performance and postural control, the contribution of the proximal muscle groups of the hip and trunk still receives little attention. The objective of this study was to assess the association between muscle function of hip abductors and adductors and trunk flexors and extensors muscles with the performance of static and dynamic balance and functionality of community-dwelling older adults. Methods: eighty-one elderly of both sexes underwent assessment of balance and functionality through: (1) tandem gait test on the Balance Master force platform (Neurocom International Inc., Clackamas, OR) to obtain the variable tandem gait speed and body sway velocity in the end of tandem gait; and (2) clinical tests of single-leg stance and Timed Up and Go (TUG). The participants also underwent assessment of muscle function in isokinetic dynamometer (Biodex System 4 Pro, New York, USA) through 3 maximal isometric contractions of abduction and adduction of the hip and flexion and extension of the trunk to obtain the variables peak torque (PT) and rate of force development (RFD) in proportion to body weight. The Shapiro-Wilk normality test was performed and then, Pearson correlation test (data with normal distribution) and Spearman (data with non-normal distribution) were applied. Linear regression test was applied to quantify the determination index (r2) of muscle function of the hip and trunk in balance and functionality of the elderly for those variables with significant correlation coefficient. It was adopted a significance level of 5% (p < 0.05). Results: there was correlation with a significant determination index of PT of muscle groups of the hip and trunk in the performance of balance and functionality tests. Regarding the RFD, it was found correlation with significant determination index of RFD of the hip abduction and trunk extension in the body sway velocity in the end of tandem gait and TUG; and of RFD of the trunk extension in single-leg stance. Conclusions: These findings may be clinically relevant considering that (1) different parameters of muscle function (such as PT and RDF) have different intervention strategies for their improvement and (2) problems of balance and / or functionality in the elderly may be 12 associated with impairments of RFD and PT of proximal muscles, which are parameters that can be treated.

INTRODUCTION: Cerebral Palsy (CP) is a sensorimotor disorder characterized by dysfunctional motor coordination, balance problems, and loss of selective motor control. Motor coordination exhibited as co-contraction, has been subjectively quantified using gait analysis, but recent studies have begun to objectively analyze the amount of co-contraction by collecting electromyography (EMG) data. Center of pressure excursion (COPE) measurements collected during a single leg standing test (SLST) have shown to be more valid measurements of balance in populations with motor disabilities than a SLST alone. A recent study has correlated increased COPE velocity with a lower fall risk as determined by reported fall frequency, suggesting a more objective measure of fall risk. The current study aimed to determine if the fall risk calculated by COPE velocity in children with CP is correlated with co-contraction index value in various muscle synergy groups. It was hypothesized that i) co-contraction index values will differ between high and low fall risk groups, ii) there will be preferential activation of different synergy groups within the high and low fall risk groups, and iii) there will be a negative and direct correlation between COPE velocity and co-contraction index values for all synergy groups. METHODS: Fall risk grouping was determined by average COPE velocity values calculated from previously reported fall frequency groups. Balance ability was determined by COPE measurements during a SLST on a force plate. Muscle synergy groups were determined by common muscle pairings at the hip, knee and ankle. Co-contraction indices were determined from linear envelopes plotted from muscle group EMG data. An independent t-test was run on muscle synergy groups between high and low fall risk groups. Nonparametric Analysis of Variance (ANOVA) and Tukey post-hoc tests were run on the high and low fall risk groups separately to determine differences in co-contraction index value within high and low fall risk groups. A Pearson correlation analyzed COPE velocity and co-contraction index value. RESULTS: No significant differences in muscle synergy between the high and low fall risk groups were found (p = 0.476, 0.076, 0.064, 0.364). The ANOVA and Tukey post-hoc tests for high fall risk group found significant differences in co-activation index value between the sagittal hip and frontal hip groups (p = 0.022) and sagittal hip and ankle groups (p = 0.016). Low fall risk group was found to have significant differences between the sagittal hip and frontal hip groups (p = 0.038) and frontal hip and knee groups (p = 0.012). Weak and negative correlations were found between COPE velocity and both knee and ankle groups (r = -0.309, -0.323, p = 0.059, 0.050). Negligible and insignificant correlations were found between frontal hip and sagittal hip synergies and COPE velocity ((r = 0.013, -0.068, p = 0.475, 0.367). CONCLUSION: There is insufficient evidence to claim that muscle group activations are different depending on fall risk grouped by COPE velocity. It is not currently possible to correlate COPE velocity to a specific synergy group recruitment. However, data do suggest that sagittal hip and knee strategies are recruited more than ankle and frontal hip strategies during SLST.