Made available in DSpace on 2014-12-17T15:16:12Z (GMT). No. of bitstreams: 1 MagnoJMA_DISSERT.pdf: 787384 bytes, checksum: 9029972d12d404dde0b8ff096bc451cb (MD5) Previous issue date: 2010-10-19 / Gait speed has been described as a predictive indicator of important adverse outcomes in older populations. Among the criteria to evaluate frailty, gait speed has been identified as the most reliable predictor of fragility, practical and low cost. Objective: This study assesses the discriminating capability of gait speed in determining the presence of fragility in the elderly community in northeast of Brazil. Method: We performed an observational analytic study with a transversal character with a sample of 391 community-living elders, aged 65 years or older, of both sexes, in the city of Santa Cruz-RN. Participants were interviewed using a multidimensional questionnaire to obtain sociodemographic information, physical-related and mental health-related information. The unintentional weight loss, muscle weakness, self-reported exhaustion, slow gait and low-physical activity were considered to evaluate the frailty syndrome. Gait velocity was measured as the time taken to walk the middle 4,6 meters of 8,6 meters (excluding 2 meters to warm-up phase and 2 meters to deceleration phase).We calculate the sensitivity and specificity of gait speed test in different cutoff points for the test run time, from which ROC curve was constructed as a measure of test predictive value to identify frail elders. The prevalence of frailty in Santa Cruz-RN was 17.1%. The gait speed test accuracy was 71%when speed is below 0,91m/s. Among women, the gait speed test accuracy was 80%(gait speed below 0.77m/s) and among men, the test accuracy was 86% (gait spend below 0,82%) (p<0,0001).Conclusion: our findings have clinical relevance when we consider that the detection of frailty presence by the gait speed test can be observed in elderly men and women by a simple, cheap and efficient exam / A velocidade da marcha vem sendo descrita como um indicador preditivo de importantes desfechos adversos em popula??es idosas. Entre os crit?rios para a avalia??o de fragilidade, a velocidade da marcha tem sido apontada como o preditor de fragilidade mais confi?vel, pr?tico e de baixo custo. Objetivo: este estudo avalia a capacidade de discrimina??o da velocidade da marcha na determina??o da presen?a de fragilidade em uma amostra populacional de idosos comunit?rios brasileiros. M?todo: Foi realizado um estudo observacional anal?tico de car?ter transversal com uma amostra populacional de 391 idosos comunit?rios com idade de 65 anos ou mais, de ambos os sexos, da cidade de Santa Cruz-RN. Foi utilizado um question?rio multidimensional contendo informa??es sociodemogr?gicas e relativas ? sa?de f?sica e mental. Para avalia??o da s?ndrome de fragilidade, foram considerados: a perda de peso n?o intencional, fraqueza muscular, auto-relato de exaust?o, lentid?o na marcha e baixo n?vel de atividades f?sicas. A velocidade da marcha foi avaliada a partir do desempenho ao andar uma dist?ncia de 8,6 metros livres, excluindo 2 metros para a acelera??o e 2 metros para a desacelera??o, sendo o tempo final cronometrado para os 4,6m. Foram calculadas a sensibilidade e a especificidade do teste de velocidade da marcha em diferentes pontos de corte do tempo de execu??o do teste, a partir dos quais foi constru?da a curva ROC como uma medida de valor preditivo do teste para identificar idosos fr?geis. Resultados: A preval?ncia da fragilidade no munic?pio de Santa Cruz\RN, foi de 17.1%. A acur?cia da velocidade da marcha ficou em 71% com um ponto de corte de 0,91m/s. Em rela??o ao sexo, as mulheres apresentaram uma acur?cia de 80% com um ponto de corte de 0,77m/s, e os homens uma acur?cia de 86% onde o ponto de corte ficou em 0,82m/s (p<0,0001). Conclus?o: Nossos achados possuem relev?ncia cl?nica ao consideramos que, a detec??o da presen?a de fragilidade atrav?s do teste de velocidade da marcha pode ser observada em homens e mulheres idosos atrav?s de um exame simples, barato e eficiente

Made available in DSpace on 2014-12-17T15:16:12Z (GMT). No. of bitstreams: 1 ClednaRBF_DISSERT.pdf: 812535 bytes, checksum: c8625a694488b58653a7e1eceee875a4 (MD5) Previous issue date: 2011-02-28 / Funda??o de Amparo a Pesquisa do Estado de S?o Paulo / Background: Obesity leads to alteration of lung volumes and capacities due to accumulation of fat in the chest wall and abdomen. Few studies have shown that weight loss induced by surgery improves lung function. Our objective was to evaluate the anthropometric development, pulmonary function, respiratory muscle, strength and endurance after weight loss induced by bariatric surgery. Methods: We evaluated in pre and post operative period variables of weight, BMI, NC, WHR and spirometric and respiratory pressure. Results: 39 subjects were evaluated, with age mean 35.9 ? 10.9 years, predominantly by women (76.3%). The weight mean decreased from 124.8 ? 17.5 kg to 88.8 ? 14.28 kg in post operative. The mean BMI ranged from 47,9 ? 5,6 Kg/m? to 34,3 ? 4,75 Kg/m?. There was a significant increase in FVC from 3,63 ? 0,94 to 4,01?1,03, FEV1 from 3,03 ? 0,72 to 3,39 ? 0,85, FEF 25-75% from 3,41 ? 0,72 to 3,82 ? 0,94, PEF from 6,56 ? 1,47 to 7,81 ? 1,69, ERV from 0,35 ? 0,39 to 0,66 ? 0,38, MVV ranged from 103,43 ? 22,21 to 137,27 ? 29,84, all of them to p<0,01. The MIP and MEP showed no significant difference in pre and post operative. It was noted that for every centimeter reduced in neck circumference, an increase of 0.06 in FVC and 5.98 in MVV is observed. This is also observed in weight and BMI. Conclusion: We conclude that weight loss induced by bariatric surgery in obese provides a significant improvement in lung function and reduction of fat around the neck is more important in the generation of lung volume than the reduction of BMI / Introdu??o: A obesidade leva a altera??o dos volumes e capacidades pulmonares devido ao ac?mulo de adiposidade no t?rax e abdome. Poucos estudos mostram que a perda de peso induzida cirurgicamente melhora a fun??o pulmonar. Entretanto apesar do elevado n?mero de cirurgias bari?tricas sendo realizadas, ainda ? necess?rio o entendimento da melhora da fun??o pulmonar em rela??o ao padr?o de adiposidade. Objetivos: Avaliar a evolu??o da fun??o pulmonar ap?s a perda de peso corporal induzida pela cirurgia bari?trica, considerando medidas espirom?tricas, de for?a e endurance muscular respirat?ria. Metodologia: Estudo observacional, descritivo de seguimento, realizado no Hospital Universit?rio Onofre Lopes no per?odo de fevereiro de 2009 a dezembro de 2010. Foram feitas avalia??es antropom?trica, espirom?tricas, medidas de press?es respirat?rias. Resultados: Foram avaliados 39 sujeitos, com m?dia de idade de 35,9 (?10,9) anos, predominantemente por mulheres (76,3%) onde o peso m?dio passou de 124,8 (?17,5) Kg para 88,8 (?14,28) Kg no p?s-operat?rio, a m?dia do IMC passou de 47,9 (?5,6) Kg/m? para 34,3 (?4,75) Kg/m?. Houve aumento significativo na CVF 3,63(?0,94) para 4,01 (?1,03), VEF1 de 3,03(?0,72) para 3,39(?0,85), a raz?o FEF 25-75% foi de 3,41 (?0,72) para 3,82 (?0,94), o PFE de 6,56 (?1,47) para 7,81 (?1,69), o VRE passou de 0,35 (?0,39) para 0,66 (?0,38), a VVM aumentou de 103,43 (?22,21) para 137,27(? 29,84) para p<0,01. Os valores de PIM?x e PEM?x n?o apresentaram diferen?a significativa no pr? e p?s-operat?rio. Foi observado que para cada quilograma de peso perdido houve aumento estatisticamente significativo de 0,06 na CVF e 1,02 na VVM. Isso tamb?m se observa com rela??o ao IMC e a circunfer?ncia do pesco?o. Para cada Kg/m? reduzido do IMC, os indiv?duos apresentam melhora de 0,03 na CVF e de 2,74 na VVM e para cada cent?metro reduzido na circunfer?ncia do pesco?o observa-se aumento de 0,06 na CVF e de 5,98 na VVM. Conclus?o: A perda de peso induzida pela cirurgia bari?trica proporciona uma melhora significativa na fun??o pulmonar. A redu??o de gordura ao redor do pesco?o se mostra mais importante na gera??o de volume para o pulm?o do que a redu??o do IMC

Made available in DSpace on 2014-12-17T15:16:12Z (GMT). No. of bitstreams: 1 TatianaSR_DISSERT.pdf: 1545029 bytes, checksum: 047ba30fa9186420d02f968d61a9ac30 (MD5) Previous issue date: 2011-02-10 / Objective: To compare the effects of the treadmill training with partial body-weight support (TPBWS) and Proprioceptive Neuromuscular Facilitation (PNF) method on gait of subjects with chronic stroke. Design: Quasi-experimental study. Setting: Laboratorial research. Participants: Twenty-three subjects (13 men and 10 women), with a mean age of 56,7 ? 8,0 years and a mean time since the onset of the stroke of 27,7 ? 20,3 months, and able to walk with personal assistance or assistive devices. Interventions: Two experimental groups underwent gait training based on PNF method (PNF group, n=11) or using the TPBWS - Gait Trainer System 2, Biodex, USA (TPBWS group, n=12), for three weekly sessions, during four weeks. Measures: Evaluation of motor function - using the Stroke Rehabilitation Assessment of Movement (STREAM) and the motor subscale of the Functional Independence Measure (motor FIM) -, and kinematic gait analyze with the Qualisys System (Qualisys Medical AB, Gothenburg, Sweden) were carried out before and after the interventions. Results: Increases in the STREAM scores (F=49.189, P<0.001) and in motor FIM scores (F=7.093, P=0.016), as well as improvement in symmetry ratio (F=7.729, P=0.012) were observed for both groups. Speed, stride length and double-support time showed no change after training. Differences between groups were observed only for the maximum ankle dorsiflexion over the swing phase (F=6.046, P=0.024), which showed an increase for the PNF group. Other angular parameters remain unchanged. Conclusion: Improvement in motor function and in gait symmetry was observed for both groups, suggesting similarity of interventions. The cost-effectiveness of each treatment should be considered for your choice / Objetivo: Comparar os efeitos do treino em Esteira com Suporte Parcial de Peso (ESPP) e do m?todo de Facilita??o Neuromuscular Proprioceptiva (FNP) na marcha de indiv?duos com hemiparesia cr?nica. Desenho: Estudo quase-experimental. Local: Pesquisa laboratorial. Participantes: Vinte e tr?s sujeitos (13 homens e 10 mulheres), com m?dia de idade de 56,7 ? 8,0 anos e tempo m?dio de les?o de 27,7 ? 20,3 meses, capazes de deambular com alguma assist?ncia pessoal ou com dispositivos auxiliares. Interven??es: Dois grupos experimentais realizaram treinamento de marcha baseado no m?todo de FNP (grupo FNP, n=11), ou utilizando o sistema de ESPP - Gait Trainer System 2, Biodex, USA - (grupo ESPP, n=12), por tr?s sess?es semanais, durante quatro semanas. Medidas: Avalia??o da fun??o motora - utilizando o protocolo Stroke Rehabilitation Assessment of Movement (STREAM) e o dom?nio motor da Medida de independ?ncia Funcional (MIF motora) -, al?m de an?lise cinem?tica da marcha com o sistema Qualisys (Qualisys Medical AB, Gothenburg, Su?cia), foram realizadas antes e ap?s as interven??es. Resultados: Houve aumento dos escores do STREAM (F=49,189; P<0,001) e da MIF motora (F=7,093; P=0,016), al?m de melhora na raz?o de simetria (F=7,729; P=0,012) em ambos os grupos. Velocidade, comprimento da passada e tempo de duplo suporte n?o mostraram altera??es ap?s os treinamentos. Diferen?as entre os grupos foram observadas apenas para a m?xima dorsiflex?o do tornozelo no balan?o (F=6,046; P=0,024), a qual exibiu aumento no grupo FNP. Demais vari?veis angulares n?o sofreram altera??es. Conclus?o: Melhora na fun??o motora e na simetria da marcha foi observada em ambos os grupos, aludindo a uma similaridade das interven??es. O custo-benef?cio de cada tratamento deve ser considerado para sua escolha

Made available in DSpace on 2014-12-17T15:16:12Z (GMT). No. of bitstreams: 1 ValeskaFS_DISSERT.pdf: 1139722 bytes, checksum: 021d8b35c469b4879fc2148facd014a1 (MD5) Previous issue date: 2011-02-28 / Introduction: Actually the obesity is a public health problem throughout the world. Bariatric surgery has been an efficient method of weight reduction body in severe obesity, reducing its associated effects and presenting low levels of immediate and late postoperative complications. In Brazil, bariatric surgery asa recent therapeutic that has been growing recently. Being Brazil a country with continental dimensions and with a huge diversity socioeconomic and cultural, it is essential to understand the reality of patients undergoing bariatric surgery in less economically privileged regions of Brazil. Objectives: To evaluate the epidemiological, clinical outcomes and mortality of patients undergoing videolaparoscopic bariatric surgery through the public health system in the Brazilian state of Rio Grande do Norte- Brazil. Methods: Observational descriptive study of a prospective, carried out from February 2009 to February 2011, the Clinic Obesity and Bariatric Surgery at Universitary Hospital Onofre Lopes - Federal University of Rio Grande do Norte (HUOL-UFRN). Anthropometric measures, comorbidity and deaths register were made in the postoperative period. Results: Seventy patients (54 women) with low income aged 22 to 63 years completed the study. We recorded the death of three patients during the study period. The results show significant decrease anthropometric parameters, especially in relation to body weight, waist circumference and hipin both sexes. Only Waist / Hip ratio showed no difference after intervention in male patients It had a resolution of comorbidities. No significant differences in reports of daily sleepiness and the snoring male patients. Conclusion: Our findings attest laparoscopic bariatric surgery as an effective method reducing weight and comorbidities in morbidly obese patients / Introdu??o: A obesidade constitui hoje, um problema de sa?de p?blica em todo o mundo. A cirurgia bari?trica tem sido um eficiente m?todo de redu??o de peso corporal em obesidade grave, reduzindo seus efeitos associados e por apresentar baixos n?veis de complica??es p?s-operat?rias imediatas e tardias. No Brasil a utiliza??o da cirurgia bari?trica ? uma alternativa terap?utica recente. Por tratar-se de um pa?s com dimens?es continentais, e com uma enorme diversidade socioecon?mica e cultural, torna-se imprescind?vel conhecer a realidade de pacientes submetidos ? cirurgia bari?trica em regi?es brasileiras menos favorecidas economicamente. Objetivos: Avaliar o perfil epidemiol?gico, desfechos cl?nicos e mortalidade de pacientes submetidos ? cirurgia bari?trica videolaparosc?pica atrav?s do sistema p?blico de sa?de brasileiro no Estado do Rio Grande do Norte (UFRN)-Brasil. Metodologia: Estudo observacional descritivo de car?ter prospectivo, desenvolvido no per?odo de Fevereiro de 2009 a Fevereiro de 2011, no Ambulat?rio de Obesidade e Cirurgia Bari?trica do Hospital Universit?rio Onofre Lopes da UFRN. Foram feitas avalia??es antropom?tricas de obesidade, registro de comorbidades e ?bitos no p?s-operat?rio. Resultados: Setenta pacientes (54 mulheres e 16 homens) de baixo poder aquisitivo com idade entre 22 a 63 anos fizeram parte do estudo. Foram registradas a morte de tr?s pacientes no per?odo do estudo. Os resultados apontam diminui??o significativa dos par?metros antropom?tricos, principalmente em rela??o ao peso corporal, circunfer?ncia de cintura e quadril em ambos os sexos. Apenas a medida de Rela??o Cintura/Quadril n?o apresentou diferen?a ap?s interven??o nos pacientes do sexo masculino. Houve uma expressiva resolu??o das comorbidades avaliadas. N?o observamos diferen?as significativas ao relato de sonol?ncia matutina na amostra em geral, e ao ronco nos pacientes do sexo masculino. Conclus?o: Nossos achados atestam a cirurgia bari?trica videolaparosc?pica como m?todo eficiente de redu??o de peso e de comorbidades em pacientes obesos m?rbidos

Made available in DSpace on 2014-12-17T15:16:15Z (GMT). No. of bitstreams: 1 GabrielaLG_DISSERT.pdf: 1470430 bytes, checksum: ea3bc897f45e188adbfbdac9bffb8d18 (MD5) Previous issue date: 2011-12-19 / Among the therapeutic approaches that can be used to achieve this goal is the gait training on sloping surfaces, but there are few scientific findings that elucidate the results of this practice. OBJECTIVE: To evaluate the effects of training on sloping surfaces on the gait of subjects with chronic hemiparesis. MATERIALS AND METHODS: A controlled, randomized, blinded clinical trial was conducted. Concluded the study twenty-four subjects with age between 40 and 70 years (54,91?9,3). Their neurological function, functional independence, motor function and balance assessed, besides the gait evaluation through kinemetry. The subjects were allocated into two groups: control group (CG) underwent gait training on treadmill with partial body weight support (PBWS) without inclination; and the experimental group (EG) submitted to gait training on treadmill with PBWS and inclination of 10%. Twelve training sessions were performed. The paired t Student test and Wilcoxon test were used in statistical analysis to compare findings before and after training for each group, and the t student test for independent samples and Mann-Whitney.test were used to compare the to groups. RESULTS: After training within-group changes were observed on balance recovery, motor function and functionality, in both experimental conditions. The EG showed changes after training on speed, stride length, step length of paretic and non-paretic side, paretic single support, double support time and non-paretic swing time. The CG the differences were detected on double support, paretic single support and hip range of movement. The EG showed better results when compared to CG on the variables: speed (p=0,034), non-paretic single support (p=0,02) and paretic swing time (p=0,02). CONCLUSION: gait training on sloping surfaces represents a promising strategy for gait training of subjects with chronic hemiparesis since it is can influence a greater number of gait variables, when compared with gait training on flat surface / Dentre as abordagens terap?uticas que podem ser utilizadas para recupera??o da marcha de sujeitos com hemiparesia est? o treinamento de marcha em superf?cies inclinadas, por?m n?o existem estudos na literatura que elucidam os resultados desse tipo de pr?tica. OBJETIVO: Avaliar os efeitos do treino em superf?cies inclinadas sobre a marcha de sujeitos com hemiparesia cr?nica. MATERIAIS E M?TODOS: Foi realizado um ensaio cl?nico, controlado, randomizado e cego. Conclu?ram o estudo 24 sujeitos, com idade entre 40 e 70 anos (54,91?9,3). Estes foram avaliados quanto ao estado neurol?gico, independ?ncia funcional, fun??o motora e equil?brio, al?m da avalia??o da marcha atrav?s da cinemetria. Os sujeitos foram alocados em dois grupos: Grupo Controle (GC) submetido a treinamento de marcha em esteira com suporte parcial de peso (SPP) sem inclina??o; e Grupo Experimental (GE) submetido ao treinamento em esteira com SPP com inclina??o de 10%. Foram realizadas de 12 sess?es de treinamento. Na an?lise estat?stica o teste t de student pareado e o teste de Wilcoxon foram utilizados para compara??o dos achados de antes e depois o treinamento de cada grupo. O teste t de student para amostras independentes e o teste de Mann-Whitney foram utilizados para compara??o entre os grupos. RESULTADOS: Ambos os grupos apresentaram altera??es ap?s o treinamento quanto equil?brio, fun??o motora e funcionalidade. O GE apresentou altera??es ap?s a interven??o quanto a velocidade, comprimento da passada, comprimento do passo par?tico e n?o par?tico, do tempo de apoio par?tico, tempo de duplo apoio, e tempo de balan?o n?o par?tico. No GC as diferen?as ap?s o treinamento foram observadas no tempo de duplo apoio, tempo de apoio par?tico e na amplitude de movimento do quadril. Entre os grupos ap?s o treinamento o GE foi superior quanto a velocidade (p=0,034), tempo de apoio n?o par?tico (p=0,02) e tempo de balan?o par?tico (p=0,02). CONCLUS?O: O treinamento de marcha em superf?cie inclinada representa uma estrat?gia promissora para o treinamento de marcha de sujeitos com hemiparesia cr?nica uma vez que ? capaz de influenciar um maior n?mero de vari?veis da marcha quando comprado ao treinamento de marcha em superf?cies planas

Made available in DSpace on 2014-12-17T15:16:15Z (GMT). No. of bitstreams: 1 LarissaCLT_DISSERT.pdf: 1897660 bytes, checksum: f5f73ae1d43d82964c26599045fa5f10 (MD5) Previous issue date: 2011-12-16 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior / Introduction: The intrinsic gait disorders in individuals with Parkinson's disease (PD) are one of the most disabling motor symptoms. Among the therapeutic approaches used in attempts to improve the motor function, especially the gait pattern of individuals, stands out the treadmill gait training associated with the addition of load. However, there are few findings that elucidate the benefits arising from such practice. Objective: To assess the effects of adding load on the treadmill gait training in individuals with PD. Material and Methods: A controlled, randomized and blinded clinical trial, was performed with a sample of 27 individuals (18 men and 9 women) with PD, randomly assigned to three experimental conditions, namely: treadmill gait training (n=9), treadmill gait training associated with addition of 5% load (n=9) and treadmill gait training associated with addition of 10% load (n=9). All volunteers were assessed, during phase on of Parkinson's medication, regarding to demographic, clinical and anthropometric (identification form) data, level of disability (Hoehn and Yahr Modified Scale), cognitive function (Mini Mental State Examination), clinical functional - in those areas activity of daily living and motor examination (Unified Parkinson's Disease Rating Scale - UPDRS) and gait cinematic analysis was performed through Qualisys Motion Capture System?. The intervention protocol consisted of gait training in a period of 4 consecutive weeks, with three weekly sessions, lasting 30 minutes each. The post-intervention assessment occurred the next day after the last training session, which was performed cinematic analysis of gait and the UPDRS. Data analysis was performed using the software Statistical Package for Social Sciences? (SPSS) 17.0. Results: The age of volunteers ranged from 41 to 75 years old (62,26 ? 9,07) and the time of clinical diagnosis of PD between 2 to 9 years (4,56 ? 2,42). There was a reduction regarding the score from motor exam domain (p=0,005), only when training with the addition of a 5% load. As for the space-time variables there was no significant difference between groups (p>0,120); however, the training with addition of 5% load presented the following changes: increase in stride length (p=0,028), in step length (p=0,006), in time balance of the most affected member (p=0,006) and reduction in support time of the referred member (p=0,007). Regarding angular variables significant differences between groups submitted to treadmill gait training without addition load and with 5% of load were observed in angle of the ankle at initial contact (p=0,019), in plantar flexion at toe-off (p=0,003) and in the maximum dorsiflexion in swing (p=0,005). While within groups, there was a reduction in amplitude of motion of the ankle (p=0,048), the only workout on the treadmill. Conclusion: The treadmill gait training with addition of 5% load proved to be a better experimental condition than the others because it provided greater gains in a number of variables (space-time and angular gait) and in the motion function, becoming a therapy capable of effectively improving the progress of individuals with PD / Introdu??o: As desordens da marcha em indiv?duos com doen?a de Parkinson (DP) representa um dos sintomas motores mais incapacitantes. Dentre as abordagens terap?uticas empregadas, na tentativa de aperfei?oar a fun??o motora, principalmente o padr?o de marcha, destaca-se o treino de marcha na esteira associado ? adi??o de carga. Todavia, poucos s?o os achados que elucidam os benef?cios oriundos de tal pr?tica. Objetivo: Verificar os efeitos da adi??o de carga no treino de marcha na esteira em indiv?duos com DP. Materiais e M?todos: Trata-se de um ensaio cl?nico, controlado, randomizado e cego, realizado com uma amostra de 27 indiv?duos com DP (18 homens e 9 mulheres), distribu?dos aleatoriamente, em tr?s condi??es: treino de marcha na esteira (n=9), treino de marcha na esteira com adi??o de 5% de carga (n=9) e treino de marcha na esteira com adi??o de 10% de carga (n=9). Todos os volunt?rios foram avaliados, estando na fase on do medicamento antiparkinsoniano, quanto aos dados demogr?ficos, cl?nicos e antropom?tricos (formul?rio de identifica??o), n?vel de incapacidade f?sica (escala de Hoehn e Yahr modificada), fun??o cognitiva (mini-exame do estado mental), estado cl?nico-funcional em rela??o aos dom?nios atividade de vida di?ria e exame motor (Unified Parkinson s Disease Rating Scale UPDRS) e a an?lise cinem?tica da marcha foi realizada por meio do sistema Qualisys Motion Capture System?. O protocolo de interven??o consistiu num per?odo de 4 semanas consecutivas de treino, sendo 3 sess?es semanais, com dura??o de 30 minutos cada. A an?lise dos dados foi realizada por meio do software Statistical Package for Social Sciences? (SPSS) 17.0, adotando-se n?vel de signific?ncia de 5%. Resultados: A idade dos volunt?rios variou entre 41 e 75 anos (62,26 ? 9,07) e o tempo de diagn?stico cl?nico da DP entre 2 e 9 anos (4,56 ? 2,42). Houve diminui??o do escore quanto ao dom?nio exame motor (p=0,005), apenas no treino com adi??o de 5% de carga. Quanto ?s vari?veis espa?o-temporais n?o foram encontradas diferen?as significativas entre os grupos (p>0,120); entretanto, o treino com adi??o de 5% de carga apresentou as seguintes altera??es: aumento no comprimento da passada (p=0,028), no comprimento do passo (p=0,006), no tempo de balan?o do membro mais afetado (p=0,006) e redu??o no tempo de apoio, do membro referido (p=0,007). Em rela??o ?s vari?veis angulares foram verificadas diferen?as significativas, entre os grupos submetidos ao treino apenas na esteira e com adi??o de 5% de carga, no ?ngulo do tornozelo no contato inicial (p=0,019), na flex?o plantar no toe-off (p=0,003) e na m?xima dorsiflex?o no balan?o (p=0,005). Enquanto que, dentro dos grupos, houve redu??o na amplitude de movimento do tornozelo (p=0,048), no treino apenas na esteira. Conclus?o: O treino de marcha na esteira com adi??o de 5% de carga demonstrou ser uma condi??o experimental superior ?s demais, por ter proporcionado ganhos em uma maior quantidade de vari?veis (espa?o-temporais e angulares da marcha) e na fun??o motora, tornando-se uma terapia capaz de beneficiar efetivamente a marcha de indiv?duos com DP

Made available in DSpace on 2014-12-17T15:16:16Z (GMT). No. of bitstreams: 1 ThalitaMFM_DISSERT.pdf: 2032843 bytes, checksum: 9ea6f3e9fb105a501058c91a0eb94bfc (MD5) Previous issue date: 2012-01-05 / Introduction: The leukemias are the most common malignancy in children and adolescents. With the improvement in outcomes, there is a need to consider the morbidity to generate the protocols used in children under treatment. Aim: To evaluate pulmonary function in children with acute leukemia. Method: This study is an observational cross sectional. We evaluated 34 children distributed in groups A and B. Group A comprised 17 children with acute leukemia in the maintenance phase of chemotherapy treatment and group B with 17 healthy students from the public in the city of Natal / RN, matched for gender, age and height. The thoracic mobility was evaluated by thoracic expansion in the axillary and xiphoid levels. Spirometry was measured using a spirometer Microloop Viasys ? following the rules of the ATS and ERS. Maximal respiratory pressures were measured with digital manometer MVD300 (Globalmed ?). The maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP) were measured from residual volume and total lung capacity, respectively. The data were analyzed using the SPSS 17.0 software assigning the significance level of 5%. Descriptive analysis was expressed as mean and standard deviation. T'student test was used to compare unpaired values found in group A with group B values, as well as with the reference values used. To compare the respiratory coefficients in the axillary level with the xiphoid in each group, we used paired testing t student. Results: Group A was significantly decreased thoracic mobility and MIP compared to group B, and MIP compared to baseline. There was no significant difference between spirometric data from both groups and the values of group A with the reference values Mallozi (1995). There was no significant difference between the MIP and MEP values and lower limits of reference proposed by Borja (2011). Conclusion: Children with acute leukemia, myeloid or lymphoid, during maintenance phase of chemotherapy treatment have reduced thoracic mobility and MIP. However, to date, completion of clinical treatment, the spirometric variables and the strength of the expiratory muscles appear to remain preserved in children between five and ten years / Introdu??o: As leucemias constituem a doen?a maligna mais frequente em crian?as e adolescentes. Com a melhora no progn?stico, surge a necessidade de considerar a morbidade que os protocolos utilizados geram nas crian?as em tratamento. Objetivo: Avaliar a fun??o pulmonar de crian?as com leucemia aguda. M?todo: Trata-se de um estudo observacional do tipo anal?tico transversal. Foram avaliadas 34 crian?as, alocadas nos grupos A e B. O grupo A foi formado por 17 crian?as com leucemia aguda na fase de manuten??o do tratamento quimioter?pico e o grupo B por 17 estudantes saud?veis da rede p?blica do munic?pio de Natal/RN, pareados em rela??o a g?nero, idade e altura. A mobilidade tor?cica foi avaliada por meio de cirtometria tor?cica nos n?veis axilar e xif?ide. A espirometria foi mensurada utilizando o espir?metro Microloop Viasys? seguindo as normas da ATS e ERS. As press?es respirat?rias m?ximas foram mensuradas com o manovacu?metro digital MVD300 (Globalmed?). As press?es inspirat?rias m?ximas (PIm?x) e as press?es expirat?rias m?ximas (PEm?x) foram medidas a partir do volume residual e da capacidade pulmonar total, respectivamente. Os dados foram analisados atrav?s do software SPSS 17.0 atribuindo-se o n?vel de signific?ncia de 5%. A an?lise descritiva foi expressa atrav?s de m?dia e desvio padr?o. Foi utilizado o teste t student n?o pareado para compara??o dos valores encontrados no grupo A com os valores do grupo B, bem como com os valores de refer?ncia utilizados. Para compara??o entre os coeficientes respirat?rios no n?vel axilar com o n?vel xif?ide em cada grupo, utilizou-se o teste t student pareado. Resultados: O grupo A apresentou diminui??o significativa da mobilidade tor?cica e da PIm?x quando comparado ao grupo B, bem como da PIm?x quando comparada aos valores de refer?ncia. N?o houve diferen?a significativa entre os dados espirom?tricos dos dois grupos avaliados e os valores do grupo A com os valores de refer?ncia de Mallozi (1995). Tamb?m n?o existiu diferen?a significativa entre os valores de PIm?x e PEm?x e os valores de limites inferiores propostos como refer?ncia por Borja (2011). Conclus?o: As crian?as com leucemia aguda, linf?ide ou miel?ide, durante o per?odo de manuten??o do tratamento quimioter?pico apresentam redu??o da mobilidade tor?cica e da for?a muscular inspirat?ria. Entretanto, at? este momento, de conclus?o do tratamento quimioter?pico, as vari?veis espirom?tricas e a for?a dos m?sculos expirat?rios parecem manter-se preservadas em crian?as entre cinco e dez anos

Made available in DSpace on 2014-12-17T15:16:16Z (GMT). No. of bitstreams: 1 JanainaMDP_DISSERT.pdf: 3329925 bytes, checksum: bd99227fd454b40f0a50e6ed626ba87e (MD5) Previous issue date: 2011-08-29 / Objectives: To evaluate how to develop dynamic hyperinflation (DH) during exercise, the influence of pursed-lip breathing in (PLB) on breathing pattern and operating volume in patients with asthma. Methods: We studied 12 asthmatic patients in three moments: (1) anthropometry and spirometry, (2) submaximal incremental cycle ergometer test in spontaneous breathing and (3), submaximal incremental test on a cycle ergometer with PLB using the Opto-electronic plethysmography. Results: Evaluating the end-expiratory lung volume (EEV) during submaximal incremental test in spontaneous breathing, patients were divided into euvolume and hyperinflated. The RFL has increased significantly, the variation of the EEV group euvolume (1.4L) and decreased in group hyperinflated (0.272L). In group volume observed a significant increase of 140% in Vt at baseline, before exercise, comparing the RFL and spontaneous breathing. Hyperinflated group was observed that the RFL induced significant increases of Vt at all times of the test incremental baseline, 50%, 100% load and 66% recovery, 250%, 61.5% and 66% respectively. Respiratory rate decreased significantly with PLB at all times of the submaximal incremental test in the group euvolume. The speed of shortening of inspiratory muscles (VtRcp/Ti) in the hyperinflated increased from 1.6 ? 0.8L/s vs. 2.55 ? 0.9L/s, whereas in the RFL euvolume group ranged from 0.72 ? 0.31L/s vs. 0.65 ? 0.2L/s. The velocity of shortening of the expiratory muscles (VtAb/Te) showed similarity in response to RFL. In group hyperinflated varied vs. 0.89 ? 0.47 vs. 0.80 ? 0.36 and ? 1.17 ? 1L vs. 0.78 ? 0.6 for group euvolume. Conclusion: Different behavior in relation to EEV in patients with moderate asthma were observed, the HD and decreased EEV in response to exercise. The breathing pattern was modulated by both RFL performance as at home, making it more efficient / Objetivos: Avaliar como se desenvolve a hiperinsufla??o din?mica (HD) e as poss?veis modifica??es dos volumes pulonares operacionais durante o exerc?cio em respira??o espont?nea e respira??o em freno-labial (RFL) em pacientes asm?ticos. M?todos: Foram avaliados 12 pacientes asm?ticos em 3 momentos: (1) antropometria e espirometria, (2) teste incremental subm?ximo no cicloerg?metro em respira??o espont?nea e (3), teste incremental subm?ximo no cicloerg?metro com RFL utilizando a Pletismografia Opto-eletr?nica. Resultados: Avaliando o volume pulmonar expirat?rio final (EEV) durante o teste incremental subm?ximo em respira??o espont?nea, os pacientes foram divididos em grupo euvolume e grupo hiperinsuflado. A RFL aumentou, significativamente, a varia??o do EEV no grupo euvolume (1.4L) e diminuiu (0.272L) no grupo hiperinsuflado. No grupo euvolume observou-se aumento significativo de 140% no Vt na situa??o basal, pr?-exerc?cio, comparando a RFL e a respira??o espont?nea. No grupo hiperinsuflado foi observado que a RFL induziu aumentos significativos do Vt em todos os momentos do teste incremental, basal, 50%, 100% da carga e recupera??o em 66%, 250%, 61.5% e 66% respectivamente. A frequ?ncia respirat?ria diminuiu significativamente com a RFL em todos os momentos do teste incremental subm?ximo no grupo euvolume. A velocidade encurtamento dos m?sculos inspirat?rios (VtRcp/Ti) no grupo hiperinsuflado aumentou de 1.6 ? 0.8L/s vs. 2.55 ? 0.9L/s, com a RFL enquanto que no grupo euvolume variou de 0.72 ? 0.31L/s vs. 0.65 ? 0.2 L/s. A velocidade de encurtamento dos m?sculos expirat?rios (VtAb/Te) demonstrou similaridade em resposta a RFL. No grupo hiperinsuflado variou 0.89 ? 0.47 vs. 0.80 ? 0.36 e no grupo euvolume em 1.17 ? 1L vs. 0.78 ? 0.6. Conclus?o: Diferentes comportamentos em rela??o ao EEV nos pacientes com asma moderada foram observados, a HD e diminui??o do EEV em resposta ao exerc?cio. O padr?o respirat?rio foi modulado pela RFL tanto em exerc?cio como no repouso, tornando-o mais eficiente

Made available in DSpace on 2014-12-17T15:16:16Z (GMT). No. of bitstreams: 1 AlineMCF_DISSERT.pdf: 1723122 bytes, checksum: 0a4e97f29c8c006b640688fc375b18da (MD5) Previous issue date: 2012-02-28 / The reduction of physiological capacity present in the process of aging causes a marked decline in lung function. The exercise does promote several positive changes in the physical health of people and protect the cardiorespiratory function. The aim of this study was to investigate the effects of a program of Pilates exercices on the strengh and electrical activity of respiratory muscles of elderly. This is a randomized, controlled clinical trial, evaluating 33 elderly aged 65 and 80 (70.88 ? 4.32), healthy, sedentary, without cognitive impairment and able the practice physical activity. The sample was divided into two groups, one experimental group with 16 elderly women who did Pilates exercises and a control group (17) that was not submitted to the exercises, but received educational booklets on aging and health care. The elderly were evaluated initially and after a period of three months, taking into account the Maximal Inspiratory Pressure (MIP) and Maximal Expiratory Pressure (MEP), obtained by Manovacuometry and intensity of EMG activity was measured using the values of Root Mean Square (RMS) for the diaphragm and rectus abdominis muscles, during the course of diaphragmatic breathing and MIP maneuver. Data were analyzed using SPSS version 17.0. For all tests, we used a significance level or p value < 0.05 and confidence interval 95%. RMS in diaphragm and rectus abdominis muscles in both tests increased, but the data were significant for the rectus abdominis during diaphragmatic breathing (p = 0.03) and the diaphragm during the MIP maneuver (p = 0.01). There was no significant variation of the MIP and MEP. Pilates exercises were responsible for increasing the electrical activation of the diaphragm and rectus abdominis muscles in a group of healthy elderly, but had no influence on changes in strength of respiratory muscles / A deteriora??o das fun??es fisiol?gicas est?o ligadas ao decl?nio do desempenho f?sico dos indiv?duos idosos. O exerc?cio promove altera??es positivas na sa?de, incluindo benef?cios cardiorrespirat?rios e aperfei?oamento do desempenho muscular e funcional, sendo fator de desacelera??o ou revers?o de preju?zos causados pelo envelhecimento. O M?todo Pilates ? muito utilizado na pr?tica cl?nica visando promover o reequil?brio muscular com exerc?cios que d?o ?nfase ao powerhouse, exigindo que o indiv?duo mantenha a mente concentrada no n?cleo do corpo o tempo todo, atrav?s da respira??o. Apesar da grande popularidade do m?todo, h? car?ncia de estudos cient?ficos com aplica??o na Fisioterapia e com abordagens cinesiol?gica, fisiol?gica e/ou biomec?nica, em especial envolvendo os m?sculos respirat?rios. O objetivo foi investigar os efeitos de um programa de exerc?cios de Pilates sobre a for?a e atividade el?trica dos m?sculos respirat?rios de idosas. Foram avaliadas 33 idosas saud?veis, sedent?rias, sem defici?ncia cognitiva e aptas ? pr?tica de exerc?cio f?sico e divididas em 2 grupos, Controle (n=17), que recebeu cartilhas educativas com orienta??es sobre envelhecimento e sa?de e Experimental (n=16), que al?m das cartilhas, passou por um programa de 24 sess?es de exerc?cios de Mat Pilates. As idosas foram avaliadas inicialmente e ap?s um per?odo de tr?s meses, levando-se em conta as medidas das press?es respirat?rias est?ticas m?ximas (PIm?x e PEm?x) e o RMS dos m?sculos diafragma e reto abdominal em dois testes diferentes. Foi utilizado o teste T de Student para compara??o entre os grupos e adotado um n?vel de signific?ncia p valor < 0,05 e intervalo de confian?a de 95%. A idade m?dia foi de 70,88 anos (?4,32). O RMS aumentou nos dois m?sculos avaliados em ambos os testes, por?m os dados foram significativos para o reto abdominal durante a respira??o diafragm?tica (p = 0,03) e para o diafragma durante a manobra de PIm?x (p = 0,01). N?o houve varia??o significativa dos valores de for?a. Os exerc?cios de Pilates alteraram a atividade el?trica, mas n?o tiveram influ?ncia na for?a dos m?sculos respirat?rios num grupo de idosas saud?veis

Made available in DSpace on 2014-12-17T15:16:17Z (GMT). No. of bitstreams: 1 DeboraCO_DISSERT.pdf: 1424041 bytes, checksum: cd4a0af380c025f38f33ae7e6e4a59a4 (MD5) Previous issue date: 2012-12-17 / Stroke is a neurological dysfunction of vascular origin that causes physical impairments and disabilities. Brazil leads the statistics stroke mortality among Latin American countries, demonstrating still be a neglected disease in this country. The incidence is related to risk factors and still is great misinformation in our country about stroke, treatment and prophylaxis. The aim of this study was to assess the degree of knowledge about stroke and patients need to use educational booklet for physiotherapy. The sample consisted of 53 patients, 22 females and 31 males, mean age 56.2 ? 10.9 years. Patients were evaluated by completing questionnaires, observing the socio-demographic and clinical aspects, neurological assessment, functional assessment, knowledge of pathology and presenting educational booklet. The data were analyzed using the chi-square test. According to the results, it was observed that the patients had not enough knowledge about the terminology, complications and warning signs of stroke, were not aware and did not perform the proper positioning of the limb and transfers, however, were aware and performed the stretching maneuvers. This reveals the need to implement policies that lead to information about stroke population. Following discharge from outpatient physical therapy using educational booklets with guidelines on positioning, stretching exercises and transfer is important in functional rehabilitation and encouraging independence of the individual affected by stroke / O Brasil lidera as estat?sticas de mortalidade por AVC entre os pa?ses da Am?rica Latina, demonstrando ainda ser uma doen?a negligenciada neste pa?s. A incid?ncia est? relacionada aos fatores de risco e ainda ? grande a desinforma??o em nosso pa?s sobre o AVC, o tratamento e a profilaxia. O objetivo desse estudo foi avaliar o grau de conhecimento de pacientes sobre o AVC e a necessidade do uso de cartilha educativa para orienta??o fisioterap?utica. A amostra foi composta de 53 pacientes, 22 do sexo feminino e 31 do sexo masculino, com idade m?dia 56,2?10,9 anos. Os pacientes foram avaliados atrav?s do preenchimento de question?rios, observando-se os aspectos s?cio-demogr?ficos e cl?nicos, avalia??o neurol?gica, avalia??o funcional, conhecimento da patologia e apresenta??o de cartilha educativa. Os dados foram analisados atrav?s do teste Qui-quadrado. De acordo com os resultados encontrados, observou-se que os pacientes n?o tinham conhecimento satisfat?rio sobre a terminologia, sinais de alerta e complica??es do AVC, n?o conheciam e n?o realizavam o posicionamento adequado do membro e as transfer?ncias, por?m, apresentavam conhecimento e realizavam as manobras de alongamento. Isso revela a necessidade de implanta??o de pol?ticas p?blicas que levem ? popula??o informa??es sobre o AVC. Ap?s a alta do tratamento fisioterap?utico ambulatorial a utiliza??o de cartilhas educativas com orienta??es sobre posicionamento, realiza??o de alongamentos e transfer?ncia ? importante na reeduca??o funcional e incentivo ? independ?ncia do indiv?duo acometido por AVC