O acidente vascular encefálico (AVE) é uma desordem neurológica aguda, de origem vascular, que pode gerar alterações de postura e equilíbrio nos pacientes acometidos. Este trabalho teve como objetivo avançar com o conhecimento relacionado à presença de alterações posturais e de equilíbrio em pacientes pós-AVE, com a utilização da fotogrametria digital e da estabilometria estática. Participaram desse estudo 31 pacientes hemiparéticos pós-AVE que foram divididos em três grupos de alterações motoras: Hemiparesia à direita (n=16), Hemiparesia à esquerda (n=15) e um grupo com a junção dos grupos Hemi D e Hemi E (n=31). Para a análise estatística da fotogrametria e da estabilometria, nas comparações intergrupo, foi utilizada a análise de variância de uma via (ANOVA) (significância p<0,05). Sempre que se detectaram diferenças entre os dados, essas foram evidenciadas pelo teste post hoc de Holm Sidak. Nas comparações intragrupo foi utilizado o teste em t (significância p<0,05). Os padrões posturais encontrados por meio da fotogrametria foram comparados com os dados da estabilometria, utilizando o coeficiente de correlação de Pearson (significância r0,80). Os dados da fotogrametria que evidenciaram desvios posturais foram: Acrômio D mais alto no grupo hemi. à E, e acrômio E mais alto no grupo hemi. à D (F6,154=8,26; p<0,05); EIAS E mais alta no grupo hemi. à D e elevação da EIAS D no grupo hemi. à E (F6,154=5,49; p<0,05); uma menor distância entre os acrômios e as EIAS D no grupo hemi. à E e menor distância entre acrômios e EIAS E no grupo hemi. à D (F6,154=6,16; p<0,05) e abdução da escápula E no grupo hemi. à D e abdução da escápula D no grupo hemi. à E (F6,154=7,54; p<0,05). A análise estabilométrica evidenciou: maior quantidade de pacientes com desvio posterior e à esquerda, independente do lado da hemiparesia; maior quantidade significativa de deslocamento posterior nos três grupos: grupo hemiparesia D/E (t = 4,20; p <0,05), grupo hemiparesia D (t = 3,04; p <0,05) e grupo hemiparesia E (t = 2,81; p <0,05) e desvio para a esquerda significativamente maior nos três grupos: grupo hemiparesia D/E (t = 5,73; p <0, 05), grupo hemiparesia D (t = 3,78; p <0, 05) e grupo hemiparesia E (t = 4,89; p <0, 05). A análise de correlação mostrou uma forte relação entre grande parte dos padrões da fotogrametria quando comparados aos da estabilometria. Dessa maneira, podemos concluir que pacientes hemiparéticos pós-AVE apresentam elevação de ombro e pelve, menor distância entre ombro e pelve e escápula abduzida do lado oposto ao da hemiparesia, que, independente do lado da hemiparesia, esses pacientes apresentaram um padrão de deslocamento posterior e à esquerda do centro de pressão e que problemas de equilíbrio se correlacionam com problemas posturais. / Stroke is an acute neurological disorder of vascular origin, which can alter equilibrium and posture in affected patients. This study aimed to advance the knowledge about the presence of postural and balance alterations in post-stroke patients using digital photogrammetry and static stabilometry. Participated in this study 31 post-stroke hemiparetic patients who were divided into three groups of motor disorders: right hemiparesis (n=16), left hemiparesis (n=15) and a group with the summation of groups right Hemi. and left Hemi. (n=31). For statistical analysis of photogrammetry and stabilometry in intergroup comparisons, analysis of one-way variance (ANOVA) (significance p<0.05) was used. When differences were detected between the data, they were evidenced by the post hoc Holm Sidak test. In the intra-group comparisons t test was used (significance p<0.05). Postural patterns found by photogrammetry were compared with stabilometry data using the Pearson correlation coefficient (significance r0,80). The Photogrammetry data that showed postural deviations were: right acromion highest in left hemi. group and left acromion higher in right hemi. group (F6,154=8.26; p<0.05). Left ASIS highest in right hemi. group and the elevation of the right ASIS in the left hemi. group (F6,154=5.49, p<0.05). A smaller distance between the right acromion and ASIS in the left hemi. group and shorter distance between the left acromion and ASIS in the right hemi group (F6,154=6.16; p<0.05) and abduction of the left scapula in the right hemi. group and right scapula abduction in the left hemi. group (F6,154=7.54, p<0.05). The stabilometric analysis showed: greater number of patients with posterior and left- deviation independent of the hemiparesis side; most significant amount of posterior displacement in the three groups: right/left hemiparesis group (t=4.20; p<0.05), right hemiparesis group (t=3.04; p<0.05) and left hemiparesis group (t=2.81; p<0.05) and left shift was significantly higher in three groups: right/left hemiparesis group (t=5.73; p<0, 05), right hemiparesis group (t=3 78; p <0, 05) and left hemiparesis group (t=4.89; p<0, 05). Correlation analysis showed a strong relationship between great part of patterns of photogrammetry compared to the estabilometry. Thus, we conclude that post-stroke hemiparetic patients have elevated shoulder and pelvis, shortest distance between the shoulder and pelvis and abducted scapula on the opposite side of hemiparesis, that, regardless of the side hemiparesis, these patients showed a pattern of posterior and left displacement of the center of the pressure and that balance problems correlate with postural problems.

Submitted by Nadir Basilio (nadirsb@uninove.br) on 2018-07-17T21:39:39Z No. of bitstreams: 1 Juliana Teles Tavares.pdf: 1123645 bytes, checksum: 9e99e680358658c37b4d41e510f9513a (MD5) / Made available in DSpace on 2018-07-17T21:39:39Z (GMT). No. of bitstreams: 1 Juliana Teles Tavares.pdf: 1123645 bytes, checksum: 9e99e680358658c37b4d41e510f9513a (MD5) Previous issue date: 2016-12-16 / The practice of physical exercise has been an important alternative to minimize the effects of age on postural control, however, there is a possibility that interruption of training (detraining) may contribute to the performance of static balance return to pre- training. The objective of this study was to analyze the action of multicomponent physical exercise on the postural control of the elderly and its effects after the period of detraining. The postural control of 31 women aged 60 to 80 years was evaluated in six different conditions on a force platform in the following conditions: static position with and without visual afferent (open eye and closed eye); Static position with the use of a foam on the platform with and without visual gauge; Static position with visual and auditory stimulation with and without the use of foam on the force platform. These variables were used to analyze the effects of two types of training for the elderly, being divided into two groups: Multicomponent Group (GM): training with strength, aerobic, balance and flexibility exercises and Control Group (CG): training with Aerobic exercise and flexibility. All participants underwent a 16-week training period, three times a week (total of 48 sessions). The postural control was analyzed before and after the training period and with 6 weeks of training. In the analysis of variance (ANOVA) it was possible to verify that the training provided significant (F = 24.72, p <0.0001) in the oscillation frequency between the groups (multicomponent group vs control group). The multicomponent group showed a significant decrease in the oscillation frequency after the training period (p <0.05), but the values observed after the training period were not different from those observed in the pre-training (p> 0.05). In this study it was possible to observe that sixteen-week training with multi-component exercises improves the postural control of elderly women. However, these effects are not maintained after a six-week period of detraining. / A prática de exercícios físicos tem sido uma alternativa importante para minimizar os efeitos da idade sobre o controle postural, porém, existe a possibilidade de que a interrupção do treinamento (destreino) possa contribuir para que o desempenho do equilíbrio estático retorne aos valores de pré-treinamento. O objetivo deste estudo foi analisar a ação do exercício físico multicomponente no controle postural de idosas e seus efeitos após período de destreino. O controle postural de 31 mulheres com idade entre 60 e 80 anos foi avaliado em seis diferentes condições sobre uma plataforma de força nas seguintes condições: posição estática com e sem aferência visual (olho aberto e olho fechado); posição estática com o uso de uma espuma sobre a plataforma com e sem aferência visual; posição estática com estímulo visual e auditivo com e sem o uso de espuma sobre a plataforma de força. Estas variáveis foram utilizadas para as análises dos efeitos de dois tipos de treinamento para idosas, sendo essas divididas em dois grupos: Grupo Multicomponente (GM): treinamento com exercícios de força, aeróbio, equilíbrio e flexibilidade e Grupo Controle (GC): treinamento com exercícios aeróbios e flexibilidade. Todos os participantes foram submetidos à um período de 16 semanas de treinamento, sendo estes realizados três vezes por semana (total de 48 sessões). O controle postural foi analisado pré e pós período de treinamento e com 6 semanas de destreino. Na análise de variância (ANOVA) foi possível verificar que o treinamento proporcionou diferença significativa (F=24,72; p < 0,0001) na freqüência de oscilação, entre os grupos estudados (grupo multicomponente vs grupo controle). O grupo multicomponente apresentou diminuição significativa na frequência de oscilação após o período de treinamento (p <0,05) porém, os valores observados após o período de destreino não foram diferentes dos observados no pré-treinamento (p>0,05). Nesse estudo foi possível observar que o treinamento de dezesseis semanas com exercícios multicomponentes melhora o controle postural de mulheres idosas. No entanto, esses efeitos não são mantidos após um período de destreino de seis semanas.

In this study we found out whether professional ice hockey players have better static and dynamic stability after vestibular stimulation after 20 seconds of spinning on a rotary chair compared to normal healthy population. A total of 21 probands, 8 professional men players, 1 professional woman player and 12 men from the ordinary healthy population underwent testing. Probands passed a total of 8 tests, 4 tests without vestibular stimulation and the same tests after vestibular stimulation on a rotary chair. For testing on a stabilometric platform, we used the variants parallel stance barefoot on plate, parallel stance on a foam pad, parallel stance barefoot on plate with head movement to extension, parallel stance on a foam pad with head movement to extension. The rotation time on the chair was 20 seconds at a rate of approximately 1 Hz (20 turns ± 2), followed by a stability measurement time of 30 seconds. Our measured results showed that there is not signifficant difference in static and dynamic stability between ice hockey players and healthy population after induction of vestibular stimulation.

Theoretical part of the thesis summarizes state of art in the field of interaction of sound stimuli with the vestibular system and balance control. Further it summarizes the effect of cochlear implantation on the peripheral vestibular structures and on the stance stability. Cochlear implantation is effective way of hearing rehabilitation. Nevertheless surgery in the region of the inner ear results in reduction of function of the peripheral vestibular structures on the implanted side. The functional deficit of the peripheral vestibular system induced by the surgery is well tolerated by patients and quickly spontaneously subside. Sound available to the patients after implantation is one of the important modalities needed for balance control. In patients with balance deficit was found higher reliance on hearing when maintaining stable stance. Some sounds can reduce postural sway. Namely listening to the broadband noise (such as white and pink) results in reduction of postural sway. The balance control also relies on the ability to localize sound source. Information about position of sound source can be utilized as point of reference for driving balance reactions. Experimental part of the thesis quantifies changes in stance stability in patients with cochlear implants using stabilometry. The...

vi Abstract Title: Evaluation of postural stability among deaf adults Objectives: The purpose of this diploma thesis was to compare the postural stability between the deaf and the normal hearing adults, and to find out if the statistically significant difference in measured parameters does exist. Methods: 102 subjects at the age of 20-45 years participated in this study. The experimental group consisted of 35 deaf adult subjects with congenital or early childhood deafness. The control group has been made by 67 normal hearing adult subjects. The postural stability was objectively evaluated by Footscan, the pressure measuring plate. Nine tests were passed, duration of each test was 30 seconds. The total travelled way (TTW) expressing the total path the centre of acting pressure travelled during the test and the Romberg ratio, which is the ratio of TTW values under the condition of closed and open eyes, were selected as indicators of postural stability. T-test was used to assess the statistical significance of the differences between the group of deaf adults and normal hearing group. To estimate the influence of individual characteristics of the subjects (evaluating the data from the questionnaires) to their postural stability, the ordinary least squares estimator was used. Results: The experimental group was...

L’analyse de la stabilité posturale chez l’homme a fait l’objet, ces dernières années, d’un intérêt grandissant au sein de la communauté scientifique. Le système postural permet de maintenir la stabilité du corps humain en posture statique ou dynamique. Cette capacité à maintenir cette stabilité devient critique dans le cas des sujets Parkinsoniens. La maladie de Parkinson a en effet une forte incidence sur la stabilité posturale. Un moyen efficace pour évaluer l’équilibre postural consiste à analyser les déplacements dans le plan horizontal du centre de pression du corps humain en posture orthostatique ; les trajectoires mesurées dans la direction medio-latérale (ML) et la direction Antéro-postérieure (AP) sont appelées signaux stabilométriques. Dans cette thèse, nous visons le développement de méthodes efficaces pour l’analyse de l’équilibre en posture orthostatique sous différentes conditions liées à l’entrée visuelle (yeux ouverts/yeux fermés), la position des pieds (pieds joints/pieds écartés) et en considérant d’autres facteurs comme le genre et l’âge. Dans ce cadre, nous proposons, tout d’abord, une méthode exploitant la variante EEMD (Ensemble Empirical Mode Decomposition) de la décomposition en modes empiriques (EMD) et l’analyse de la diffusion du stabilogramme. Dans le contexte du diagnostic de la maladie de Parkinson, la discrimination entre sujets sains et sujets Parkinsoniens est très importante, de même que l’évaluation du stade de la maladie pour les sujets atteints. Dans ce cadre, deux méthodes sont proposées. La première consiste tout d’abord en une extraction et sélection de caractéristiques temporelles et spectrales, à partir des signaux stabilométriques brutes ou des modes de fonctions intrinsèques dérivés de la décomposition EEMD. Des méthodes standards de type KNN, CART, RF et SVM sont ensuite appliquées pour reconnaitre les sujets Parkinsoniens. La deuxième méthode proposée, est une approche de classification qui repose sur l’emploi de HMMs construits en utilisant les signaux stabilométriques brutes dans les directions ML, AP et ML/AP. Enfin, une dernière méthode est proposée pour la segmentation automatique des signaux stabilométriques sous différentes conditions (entrée visuelle, position des pieds). Pour ce faire, un modèle de régression régi par une chaine de Markov cachée (HMMR) est utilisé pour détecter automatiquement les variations des structures des signaux stabilométriques entre ces conditions. Les résultats obtenus montrent clairement la supériorité des performances des méthodes proposées par rapport aux approches standards, aussi bien, en termes d’analyse de l’équilibre postural que de diagnostic de sujets Parkinsoniens / Recently, human balance control analysis has received an increasing interest from the research community. The human postural system maintains the stability of the body both in the static posture (quiet standing) and during locomotion. This ability to maintain stability becomes hard with aging and Parkinson's disease (PD) subjects. PD has a strong effect on postural stability during quiet standing situations, and during locomotion. One effective way to assess human stability is to analyze the center of pressure (CoP) displacements of the human body during quiet standing. The recorded CoP displacements in quiet standing are called stabilometric signals. This thesis aims to develop efficient approaches to analyze the human postural stability in quiet standing under visual and feet position conditions, as well as under age and gender. This is achieved using Empirical Mode Decomposition (EMD) method and stabilogram-diffusion technique. In the other part, the discrimination between healthy and PD subjects is very important for diagnosing Parkinson's disease, as well as for evaluating the disease level of the patient. In this context, two approaches are proposed; the first approach consists of an EMD-based temporal and spectral feature extraction from the stabilometric signals. The second approach is based on a Hidden Markov Model (HMM) using the raw stabilometric signals. The HMM model is an efficient tool to analyze temporal and sequential data. Another approach is proposed in order to segment the stabilometric signals according to the visual and feet position conditions. This is achieved using a Hidden Markov Model Regression (HMMR)-based approach. This study help clinicians to better understand the motor strategies used by the subjects during quiet standing and may guide the rehabilitation process. The obtained results clearly show high performances of the proposed approaches with respect to other standard approaches in both postural stability analysis and discrimination healthy from PD subjects

Les gonalgies et les aponévrosites plantaires représentent la majorité des motifs de consultations d’un cabinet de podologie. Les patients souffrant de ces pathologies ressentent des douleurs au niveau du genou ou du pied qui peuvent être invalidantes. Bien que le port d’orthèses plantaires représente un traitement conservateur efficace, la prescription de ce traitement repose sur une connaissance empirique des effets de ce dernier. Le but de ce travail était donc d’étudier les effets des semelles orthopédiques à dominante biomécanique (modifiant la posture) ou proprioceptive (stimulant les capteurs de la sole plantaire) sur les modifications de la stratégie neurale chez les patients souffrant de ces pathologies et de déterminer quels pouvaient être les liens avec la diminution de la douleur ressentie. Pour cela, nous avons procédé à une évaluation de la douleur, un examen de la marche, un examen stabilométrique et des enregistrements électrophysiologiques (réflexes mesurés au repos et lors d’une contraction musculaire volontaire). L’évolution de ces différents paramètres a été mesurée après trois, six et neuf semaines de port d'orthèses plantaires. Les résultats obtenus ont été comparés à ceux recueillis chez des patients témoins indemnes de toute pathologie.Même si les résultats obtenus lors de ces études ne sont pas aussi concluants que nous l’aurions souhaité et que de nombreuses questions restent encore en suspend, ce travail a permis toutefois d’ouvrir au domaine de la podologie un champ de recherche jusque-là peu ou pas exploré. / Knee pain and plantar fasciitis represent most of the reasons for consultation of a podiatrist. Patients with these pathologies experience knee or foot pain that can be disabling. Although the use of foot orthoses is an effective conservative treatment, its prescription is based on an empirical knowledge of its effects. The aim of this study was to investigate the effects of foot orthoses based on biomechanical (modifying the posture) or proprioceptive (stimulating sensors of the plantar sole) principles on neural strategy changes in suffering patients and to determine the links with the decrease in perceived pain. For this, we performed a pain assessment, walking and stabilometric examination and electrophysiological recordings (reflexes measured at rest and during voluntary muscle contraction). The evolution of these different parameters was measured after three, six and nine weeks of wearing foot orthoses. The results obtained were compared with those obtained in control patients free from any pathology.Although the results of these studies are not as conclusive as we would have liked and many questions remain unresolved, this work has opened up to the podiatry a field of research until then little or not explored.

This work deals with the metods frequency and time frequency analysis of stabilometric signal. In the introroduction is described theory about posturography and posturographic measurment. The work contains describtion of stabilometric parametrs in time domain (1D and 2D parametrs) and in frequency domain. The aim is create review of basic metods used to processing and preprocessing of stabilometric signals and comparing this methods . In work is realized ferquency analysis used Frourier transfrmation and Burg method and time-frequency analysis used Short time Frourier transformation and Wavelet transformation. One part of program is aimed on comparison of this methods.

Thesis title: The effect of kinesthetic sensation on the postural control and balance abilities of individuals with visual impairments Objectives: Compose through the literature study appropriete balance programe for the individuals with visual impairments and measure its effect on their postural control and balance abilities. Methods: Ten visually impaired subjects, one subject with visual and vestibular impairment and one healthy subject took part in this study. Movement intervention was held once a week for eleven weeks, consisting of balance and coordination training, exercises for decreasing muscle imbalances and increasing body awareness and relaxation ability. The Footscan system was used for measuring the effect of movement intervention on the on the postural control and balance abilities of individuals with visual impairments. The testing was done before the beginning and after the finishing of all classes of movement intervention and the results of the pretest and posttest were compared with each other. Results: The movement intervention led to the improvement of postural control and balance abilities at five subjects from the total of nine subjects, who underwent pre and post testing. From the total of forty-eight carried out tests, the subjects noted improvement in twenty-two tests,...

Title Ways to influence amateur s athletes postural stability Objectives The aim of this study is to describe the selected parameters of body composition and postural stability of the amateur s athletes (floorball players) group and to assess the efficiency of short-term intervention exercise based on senzomotor stimulation, acral coactivation therapy and plyometrics. Methods This work is a descriptive work, one part of it is the intervention. Two groups of amateur s athletes (floorball players) were examined during the study - intervention group(n = 16, average height = 178,23 cm (std 7,18), average weight = 80,04 (std 11,53), average age = 25,15 years (std3,31 )) and control group(n = 8, ave- rage height = 181,48 cm (std 5,59), average weight = 82,29 kg (std 11,20), average age = 27,07 let (2,68)). Each participant underwent the entrance measurement both on Footscan to evaluate the level of postural stability by selected parameters and on InBody 3.0 a Tanita to evaluate the level of body composition by selected parame- ters. Then the intervention group took part in the intervention exercise. After the six week intervention period underwent both groups the second measurement. The results of both measurements were evaluated, compared and statistically analyzed. Results The results showed great...