Avec le vieillissement de la population, l’Accident Vasculaire Cérébrale (AVC) est l’un des principaux problèmes de santé et touche 15 millions de personnes par an à travers le monde. Après un AVC, de nombreux troubles moteurs et sensoriels, qui ont un impact direct sur les activités de la vie quotidienne (AVQ), peuvent apparaître comme le manque de coordination, la spasticité ou les tremblements. Afin de rétablir au maximum leurs capacités motrices et sensorielles, les patients doivent suivre un processus de rééducation long et coûteux. De plus, le suivi et l’évaluation des patients se fait à partir d’observations visuelles. Peu voire aucune information objective et quantifiable sur la réalisation des exercices n’est collectée pendant les séances de rééducation. Ainsi, des informations potentiellement cruciales sur les capacités motrices des patients ne sont pas mesurées. De nombreuses plates-formes de rééducation et de suivi ont été développées pour collecter des informations objectives à l’aide de la réalité virtuelle, augmentée, d’écrans interactifs ou de dispositifs portables. Cependant, ces plates-formes peuvent présenter des contraintes de coût, de portabilité et d’utilisabilité.L’objectif de cette thèse est de proposer des outils permettant d’améliorer l’accompagnement des patients durant la rééducation fonctionnelle en offrant aux professionnels de santé un suivi plus représentatif de l’état de santé de ces derniers séance après séance. Ce suivi s’effectue à l’aide d’informations objectives et quantifiables sur les fonctions motrices des membres supérieurs collectées par des objets instrumentés de capteurs. Sur la base de l’état de l’art et des résultats d’une étude observationnelle réalisée auprès de quatorze professionnels de santé, nous avons développé cinq objets de rééducation instrumentés pour le suivi des fonctions motrices de la main et du bras et des activités de la vie quotidienne qui se matérialisent par : (i) un osselet qui collecte des informations sur la dextérité manuelle (position et pression des doigts, orientation, mouvements irréguliers, tremblements), (ii) un cube qui collecte des informations sur la préhension globale de la main (pression globale des doigts, orientation, mouvements irréguliers et tremblements), (iii) un bracelet connecté du commerce qui collecte des informations sur les fonctions motrices du bras (mouvements du bras, mouvements irréguliers et tremblements), (iv) un vêtement instrumenté qui mesure l’angle de flexion du coude et (v) un verre qui collecte des informations sur les fonctions motrices du bras et de la main lors de séquences d’actions complexes (niveau de liquide, orientation, position sur une cible, pression des doigts et tremblements) et qui permet de reconnaître les activités de la vie quotidienne boire, s’asseoir, se lever, marcher, monter et descendre des escaliers. Nous avons conduit une étude expérimentale auprès de quatorze professionnels de santé afin d'explorer l'ensemble des fonctionnalités ainsi que le design des objets afin de récolter des retours sur de possibles améliorations. Les résultats de cette étude nous ont permis s’assurer de la validité des fonctionnalités et de développer des interfaces de visualisation visant à afficher les données de manière simple, rapide et facile à interpréter. Nous avons mené une étude auprès de six professionnels de santé afin de valider le développement de ces interfaces. Les résultats indiquent que les choix de conception de ces interfaces de visualisation sont pertinents. Enfin, nous avons mené une étude expérimentale d’utilisabilité et d’acceptabilité auprès de neuf patients victimes d’AVC. Les résultats indiquent que les critères d’efficacité et de satisfaction de l’utilisabilité sont respectés. De plus, les patients ont jugé les objets faciles à utiliser et sont volontaires pour les utiliser pendant les séances de rééducation et à domicile afin d’adapter leur programme de rééducation en fonction de leurs progrès. / As the population ages, stroke is one of the major health problems affecting 15 million people worldwide each year. After a stroke, many motor and sensory disorders, which have a direct impact on activities of daily living (ADL), can appear as lack of coordination, spasticity or tremors. In order to restore their motor and sensory abilities as much as possible, patients must undergo a long and costly rehabilitation process. In addition, patient monitoring and evaluation is based on visual observations. Little or no objective and quantifiable information on the execution of exercises is collected during rehabilitation sessions. Thus, potentially crucial information on patients' motor abilities is not measured. Many rehabilitation and monitoring platforms have been developed to collect objective information using virtual reality, augmented, interactive screens or portable devices. However, these platforms may have cost, portability and usability constraints.The objective of this thesis is to propose tools to improve the accompaniment of patients during the process of functional rehabilitation by offering health professionals a more representative follow-up of the state of health of these, session after session. This monitoring is carried out using objective and quantifiable information on the motor functions of the upper limbs collected by objects instrumented with sensor. On the basis of the state of the art and the results of an observational study conducted with fourteen health professionals, we developed five instrumented rehabilitation objects for monitoring the motor functions of the hand and arm and the activities of daily life that are materialized by: (i) a jack that collects information on manual dexterity (finger position and pressure, orientation, irregular movements, tremors), (ii) a cube that collects information on overall hand grip (overall finger pressure, orientation, irregular movements and tremors), (iii) a commercially available connected watch that collects information on arm motor functions (arm movements), (iv) an instrumented garment that measures the bending angle of the elbow and (v) a cup that collects information on the motor functions of the arm and hand during complex action sequences (fluid level, orientation, position on a target, finger pressure and tremors) and allows the recognition of activities of daily living such as drinking, sitting, standing, walking, climbing and descending stairs. We conducted an experimental study with fourteen healthcare professionals to explore the functionalities and the design of the objects in order to gather feedback on possible improvements. The results of this study allowed us to tighten the measurement perimeter and make the objects more functional. This study also allowed us to develop visualization interfaces to display data in a simple, fast and easy to interpret manner. We conducted a study with six healthcare professionals to validate the development of these interfaces. The results indicate that the design choices of these visualization interfaces are relevant. Finally, we conducted an experimental usability and acceptability study in nine stroke patients. The results indicate that the efficiency and usability satisfaction criteria are met. The results show that patients found the objects easy to use and are willing to use them during rehabilitation sessions and at home to adapt their rehabilitation program according to their progress.

Title: Analysis of upper limbs muscles involvement during playing the drums. Objectives: The aim of this thesis is to compile information about playing the drums and summerize the most frequent musculosceletal disorders of upper extremities of these musicians. The main aim is analyzing and comparing the involvement of muscles or muscles groups of the right upper limb while drumming. Methods: The theoretical part follows up the given issue as a research and theoretical overview of the current findings based on czech and foreign literature. The practical part is dedicated to evaluation of surface electromyography and 3D kinematics analyses of movements while drumming under specified conditions of one single proband. Results: Results of measurement demonstrate that m. biceps brachii is the most active muscle during playing on hi-hat, snare drum and floor tom with forte dynamics and m. extenzor carpi uln. is is the most muscle active during play with piano dynamics. Wrist flexors were the least active during all measurements. M. extenzor carpi rad. was measured too and its activity was on second place. A close relation between changes of muscles activity and changes of angles of the elbow and wrist have not been established in this study. This research was implemented only with one proband so the...

AbstractIntroduction: Hand Arm Risk Assessment Method (HARM) is a tool to assess the risks of deve­lo­ping complaints of the arm, neck or shoulders during manual work. The method was developed in the Netherlands primarily for employers, but is also used as an aid to work environment in­spec­tors. The purpose of this study was to evaluate the HARM-method for assessment of biomecha­nical exposure of the upper limbs when performing manual tasks as well as its suitability to be used within work environment inspection. Methods: Ten labour inspectors conducted assessments of five video-recorded work tasks. Assess­ments made with HARM were compared with those made with the Assessment of Re­pe­titive Tasks (ART) tool and with ACGIH Hand Actvity Level (HAL) - both methods for assess­ment of bio­mecha­nical exposure of the upper limbs - and with the model for the assessment of re­pe­titive work in the pro­visions of the Swedish Work Environ­ment Autho­rity on ergonomics for the prevention of mus­culo­skeletal disorders, AFS 1998:1. HAL is based on a threshold limit value for hand activity. The method combines the assessment of hand activity with per­ceived effort in the hand and forearm. The assess­ments were made twice, two weeks apart. Following each assessment the inspec­tors answered questions about the suitability of each method. Three experts (X) made the same assess­­ments, first individually just like the inspectors’, and then they agreed upon a consensus estimation. Head and upper arm position were registered by inclinometer, wrist movements with electro goniometer. The observers' assessments were com­pared with a “gold standard” that was created by the results of the technical measure­ments which re­placed the consensus esti­mates for the head and arm positions as well as wrist motions in the HARM, ART and HAL assessments. Results: The inspectors' assessment of HARM and ART showed in comparison with the res­pective “gold standard” some under­esti­ma­tion of risks. Conformity in the test-retest was 68 % at appraisal with HARM and 66 % with ART. Based on the inspectors' observations it was re­vealed that force and frequency were experienced as the most difficult to assess. On the other hand the indi­vi­dual assess­ments indicated that the work position of the hand and forearm showed the lar­gest deviation. Hand activity was both over and undervalued in comparison with tech­nical measurements, suggesting that it is difficult to simply assess hand activity by ob­ser­va­tion. Fur­thermore, the model for identifying repetitive work in AFS 1998:1 was perceived to be the most difficult to use for performing assess­ments, as it has few criteria and no support for the assessment of hand/arm and hand inten­si­ve move­ments. This under­lines that there is a need for other models as a supplement to the pro­visions. Conclusions: The results showed that the HARM and ART are relatively similar in content and struc­ture and provided relatively similar results. HARM is more detailed than ART as it takes into account the vibration exposure as a single factor and shows more consideration to the duration of exposure. The HARM-method provides support for the assessment; it is easy to use, it needs pen and paper only and is in that sense readily available, it is fast and takes into account the whole of the assessment of biomechanical exposure of the upper limbs. ART is very similar to HARM; HAL is more limited and can be used as a rapid screening of hand load. / Sammanfattning Inledning: Hand Arm RiskbedömningsMetod (HARM) är ett verktyg för bedömning av be­last­ning på hand och arm vid manuellt arbete. Metoden är framtagen i Nederländerna, i första hand till arbets­gi­va­re, metoden används också som ett stöd för arbetsmiljöinspektörer. Syftet med den här studien var att utvärdera HARM-metodens tillförlitlighet och dess lämp­lig­het som hjälpmedel för arbetsmiljö­inspek­törer vid riskbedömning av belastning på hand, arm och axel vid ma­nuellt arbete. Metod: Tio observatörer tillika arbetsmiljöinspektörer genomförde bedömningar av fem video­inspe­la­de arbets­moment.  Bedömningar gjorda med HARM jämfördes med bedöm­ningar med Assessment of Repetitive Tasks (ART) och Hand Activity Level (HAL) samt modellen för bedömning av ensidigt upprepat arbete i Arbetsmiljöverkets föreskrifter om belastningsergonomi, AFS 1998:1. HAL bygger på ett gränsvärde för handaktivitet. Metoden kombinerar bedömning av handens aktivitet med upplevd ansträng­ning i hand och underarm. Bedömningarna gjordes två gånger med två veckors mellanrum. I anslutning till varje bedömning besvarades frågor om respektive metods användbarhet. Tre experter (X) gjorde först enskilt mot­sva­rande bedömningar som observatörerna och enades därefter i en kon­sen­sus­be­döm­ning. Huvudets- och över­armarnas position registrerades med inklinometer, hand­leds­rö­rel­ser med elektro­gonio­me­ter. En ”gyllene standard” som observatörernas mätningar kunde jämföras med, skapades genom att resultaten av de tekniska mätningarna ersatte konsensusbedömningen för huvud- och armposition samt handledsrörelserna för HARM, ART och HAL. Resultat: Observatörernas bedömningar med HARM och ART visade i jämförelse med respektive gyllene standard på en viss undervärdering av risker. Överensstämmelsen vid test-retest av arbets­momenten var 68 % vid bedömning med HARM och 66 % med ART. Av observatörernas synpunkter framkom att kraft­ och frekvens upplevdes svårast att bedöma. Av de enskilda bedömningarna framkom dock att det var arbets­ställning i hand och underarm som visade den största avvikelsen. Handaktivitet både över- och undervärderades i jämförelse med tekniska mätningar, vilket pekar på att det är svårt att enbart genom ob­ser­va­tion bedöma handaktivitet. Vidare framgick att AFS upplevdes vara svårast att an­vän­da som underlag till en belastnings­ergono­misk riskbedömning, då den har få kriterier och saknar bedömnings­stöd för hand/arm och hand­in­tensiva rörelser. Detta understryker att det kan behövas ett komplement till AFS. Slutsatser: Resultaten visade att HARM och ART är relativt lika till innehåll och struktur och gav förhållandevis likvärdiga resultat. HARM är mer nyanserad än ART då den dels tar hänsyn till vibrationsexponering som en enskild faktor och dels justerar för exponeringstid. HARM-metoden ger stöd vid bedömning, är snabb och lätt att använda, endast papper och penna krävs och den tar hänsyn till hel­heten vid be­döm­ning av nack- och arm belastning. ART är mycket lik HARM. HAL är mer begränsad och kan användas som en snabb screeningmetod för handbelastning.

Suite à un accident vasculaire cérébral (AVC), des déficits au membre controlatéral et ipsilatéral à la lésion cérébrale sont observés chez les personnes avec un AVC. La performance du membre ipsilatéral est déterminée par l’importance de la sévérité clinique du membre controlatéral ainsi que par l’adéquation du traitement bihémisphérique des informations sensori-motrices. L’objectif de la présente étude est de comparer la performance motrice de la main ipsilatérale lors de diverses tâches nécessitant un niveau plus ou moins complexe de traitement de l’information chez une clientèle hémiplégique ayant une faible sévérité clinique. Les résultats démontrent que les forces de pinces entre le pouce et l’index du membre ipsilatéral sont modulées et anticipées adéquatement chez les personnes avec un AVC ayant une faible sévérité clinique tel que démontré par des scores de cinq ou plus au Chedoke-McMaster Stroke Assessment (modules bras et main). La performance motrice du membre ipsilatéral lors de l’exécution d’une tâche de coordination bilatérale est comparable à celle du membre dominant des sujets sains lorsque la tâche est réalisée sans interaction entre les membres supérieurs (deux objets) et elle est perturbée lorsqu’elle implique une action coordonnée et réciproque des membres supérieurs sur un même objet. Ces personnes, ayant une bonne récupération motrice, ont donc une problématique centrale d’intégration et de traitement de l’information sensori-motrice lorsqu’il y a une complexification de la tâche à réaliser. Ces résultats suggèrent donc que les cliniciens devraient porter une attention plus particulière aux activités unilatérales et de coordination bilatérales lors le l’exécution de tâches complexes nécessitant un niveau d’intégration sensori-motrice élevé. / As a result of a cerebrovascular accident (CVA), deficits in the controlateral and ipsilateral limb of the brain lesion are observed in person who had had a CVA. The performance of the ipsilateral limb is determined by the clinical severity of the contralateral limb and by the adequacy of bi-hemispheral processing of information. The objective of the present study is to compare the motor performance of the ipsilateral hand during tasks implying different level of sensori-motor integration in patients with low clinical impairments. The results demonstrated that the pinch strengths between the thumb and the index finger of the ipsilateral limb are modulated and anticipated adequately in stroke persons who have a good motor recovery such as demonstrated by scores of five or more in the Chedoke-McMaster Stroke Assessment (arm and hand parts). The motor performance of the ipsilateral limb of stroke persons during the execution of a bilateral coordination task is comparable to the motor performance of the dominant limb of healthy subjects when the task is realized without interaction between upper limbs (two objects) and it is perturbed when it implies a coordinated and reciprocal action of upper limbs on the same object. Consequently, these stroke persons with a good motor recovery have a central problem of integration and processing of sensori-motor informations when a more complex task has to be realized. These results suggest that the clinicians should pay more attention during unilateral tasks and during tasks with bilateral coordination that require a higher level of sensori-motor integration.

La récupération optimale des amplitudes articulaires (AAs) et de la force musculaire est un objectif crucial de la réadaptation fonctionnelle intensive (RFI) à la suite d’une lésion médullaire (LM). Le but de la présente étude était de documenter les changements d’AAs des membres supérieurs durant la RFI chez des individus (n = 197) ayant subi une LM et d’établir le lien avec l’autonomie fonctionnelle. Les données (AA, force musculaire, spasticité, déficiences secondaires, autonomie fonctionnelle) ont été collectées à l’admission et au congé de la RFI. Des analyses descriptives, des tests d’association entre les changements d’AAs et des variables indépendantes (douleur, spasticité, déficiences secondaires, force) et des analyses multivariées ont été utilisées. Les individus ayant une paraplégie présentent peu de déficit d’AAs à l’épaule comparés à ceux ayant une tétraplégie. Parmi ces derniers, une majorité présente des AAs sous les valeurs de normalité en fin de RFI. Le groupe D, établi selon l’évaluation de l’American Spinal Injury Association (ASIA D) présente des pertes d’AAs plus importante qu’attendue. La douleur au niveau articulaire est un facteur influençant les changements d’AAs, particulièrement dans ce groupe. La force musculaire chez les personnes ayant une tétraplégie sévère (ASIA ABC) est plus faible que celle du groupe ayant une lésion moins sévère (ASIA D). Généralement, le gain de force corrèle avec le gain d’AA. La force musculaire, les AAs et le nombre de déficiences secondaires sont les principaux éléments influençant l’autonomie fonctionnelle. En conclusion, la perte d’AA est plus importante à l’articulation de l’épaule et, pour plusieurs individus, malgré un gain significatif, les AAs n’atteignent pas les valeurs de référence au congé de la RFI. La force musculaire et certaines déficiences secondaires sont des éléments à considérer pour expliquer les pertes d’AAs et d’autonomie fonctionnelle. Les études futures devront clarifier certains aspects dont l’atteinte de la rotation médiale qui semble montrer un patron différent de récupération en comparaison des autres mouvements de l’épaule. De plus, les études devront montrer si ces changements et résultats sont maintenus après le congé de la RFI. / Optimal recovery of range of motion (ROM) and strength are critical objectives of intensive rehabilitation following spinal cord injury (SCI). The aim of this study was to characterize the evolution of ROM and strength at the upper limb and analyze their relationship with functional independence during intensive rehabilitation. Data ROM, strength, spasticity, secondary impairments, functional independence) from 197 participants with SCI were collected at admission and discharge from intensive rehabilitation and were analyzed with descriptive statistics and multivariate analyses (regressions, ANOVA). Specific association analyses were used to determine the level of association between ROM, strength and independent variables such as pain, spasticity and secondary impairments. Lesser deficit in ROM was observed in participants with paraplegia compared to those with tetraplegia. The deficit in individuals with tetraplegia was larger to an extent that most of them did not reach normality in ROM at shoulder joint. Surprisingly, individuals with less severe injury according to the American Spinal Injury Association classification (ASIA D) showed larger deficit of ROM than expected. Joint pain was related to reduce ROM, particularly in participants with ASIA D lesion. Values of muscle strength in individuals with more severe tetraplegia (ASIA ABC) are lower than the ones observed in individuals with less severe injury (ASIA D). Overall, strength and ROM were correlated, except for medial rotation movement. ROM, strength, and secondary impairments are the major determinants of functional independence. In conclusion, shoulder joint was the most affected joint of the upper limb, and, despite of significant gains of ROM, abnormalities were greater than expected. Strength and some secondary impairment were related in loss of ROM and functional independence throughout rehabilitation. More study will be needed to understand the medial rotation movement at the shoulder that seems to evolve differently from other movements, and to determine whether or not changes observed during rehabilitation are maintained over time.

La récupération optimale des amplitudes articulaires (AAs) et de la force musculaire est un objectif crucial de la réadaptation fonctionnelle intensive (RFI) à la suite d’une lésion médullaire (LM). Le but de la présente étude était de documenter les changements d’AAs des membres supérieurs durant la RFI chez des individus (n = 197) ayant subi une LM et d’établir le lien avec l’autonomie fonctionnelle. Les données (AA, force musculaire, spasticité, déficiences secondaires, autonomie fonctionnelle) ont été collectées à l’admission et au congé de la RFI. Des analyses descriptives, des tests d’association entre les changements d’AAs et des variables indépendantes (douleur, spasticité, déficiences secondaires, force) et des analyses multivariées ont été utilisées. Les individus ayant une paraplégie présentent peu de déficit d’AAs à l’épaule comparés à ceux ayant une tétraplégie. Parmi ces derniers, une majorité présente des AAs sous les valeurs de normalité en fin de RFI. Le groupe D, établi selon l’évaluation de l’American Spinal Injury Association (ASIA D) présente des pertes d’AAs plus importante qu’attendue. La douleur au niveau articulaire est un facteur influençant les changements d’AAs, particulièrement dans ce groupe. La force musculaire chez les personnes ayant une tétraplégie sévère (ASIA ABC) est plus faible que celle du groupe ayant une lésion moins sévère (ASIA D). Généralement, le gain de force corrèle avec le gain d’AA. La force musculaire, les AAs et le nombre de déficiences secondaires sont les principaux éléments influençant l’autonomie fonctionnelle. En conclusion, la perte d’AA est plus importante à l’articulation de l’épaule et, pour plusieurs individus, malgré un gain significatif, les AAs n’atteignent pas les valeurs de référence au congé de la RFI. La force musculaire et certaines déficiences secondaires sont des éléments à considérer pour expliquer les pertes d’AAs et d’autonomie fonctionnelle. Les études futures devront clarifier certains aspects dont l’atteinte de la rotation médiale qui semble montrer un patron différent de récupération en comparaison des autres mouvements de l’épaule. De plus, les études devront montrer si ces changements et résultats sont maintenus après le congé de la RFI. / Optimal recovery of range of motion (ROM) and strength are critical objectives of intensive rehabilitation following spinal cord injury (SCI). The aim of this study was to characterize the evolution of ROM and strength at the upper limb and analyze their relationship with functional independence during intensive rehabilitation. Data ROM, strength, spasticity, secondary impairments, functional independence) from 197 participants with SCI were collected at admission and discharge from intensive rehabilitation and were analyzed with descriptive statistics and multivariate analyses (regressions, ANOVA). Specific association analyses were used to determine the level of association between ROM, strength and independent variables such as pain, spasticity and secondary impairments. Lesser deficit in ROM was observed in participants with paraplegia compared to those with tetraplegia. The deficit in individuals with tetraplegia was larger to an extent that most of them did not reach normality in ROM at shoulder joint. Surprisingly, individuals with less severe injury according to the American Spinal Injury Association classification (ASIA D) showed larger deficit of ROM than expected. Joint pain was related to reduce ROM, particularly in participants with ASIA D lesion. Values of muscle strength in individuals with more severe tetraplegia (ASIA ABC) are lower than the ones observed in individuals with less severe injury (ASIA D). Overall, strength and ROM were correlated, except for medial rotation movement. ROM, strength, and secondary impairments are the major determinants of functional independence. In conclusion, shoulder joint was the most affected joint of the upper limb, and, despite of significant gains of ROM, abnormalities were greater than expected. Strength and some secondary impairment were related in loss of ROM and functional independence throughout rehabilitation. More study will be needed to understand the medial rotation movement at the shoulder that seems to evolve differently from other movements, and to determine whether or not changes observed during rehabilitation are maintained over time.

Suite à un accident vasculaire cérébral (AVC), des déficits au membre controlatéral et ipsilatéral à la lésion cérébrale sont observés chez les personnes avec un AVC. La performance du membre ipsilatéral est déterminée par l’importance de la sévérité clinique du membre controlatéral ainsi que par l’adéquation du traitement bihémisphérique des informations sensori-motrices. L’objectif de la présente étude est de comparer la performance motrice de la main ipsilatérale lors de diverses tâches nécessitant un niveau plus ou moins complexe de traitement de l’information chez une clientèle hémiplégique ayant une faible sévérité clinique. Les résultats démontrent que les forces de pinces entre le pouce et l’index du membre ipsilatéral sont modulées et anticipées adéquatement chez les personnes avec un AVC ayant une faible sévérité clinique tel que démontré par des scores de cinq ou plus au Chedoke-McMaster Stroke Assessment (modules bras et main). La performance motrice du membre ipsilatéral lors de l’exécution d’une tâche de coordination bilatérale est comparable à celle du membre dominant des sujets sains lorsque la tâche est réalisée sans interaction entre les membres supérieurs (deux objets) et elle est perturbée lorsqu’elle implique une action coordonnée et réciproque des membres supérieurs sur un même objet. Ces personnes, ayant une bonne récupération motrice, ont donc une problématique centrale d’intégration et de traitement de l’information sensori-motrice lorsqu’il y a une complexification de la tâche à réaliser. Ces résultats suggèrent donc que les cliniciens devraient porter une attention plus particulière aux activités unilatérales et de coordination bilatérales lors le l’exécution de tâches complexes nécessitant un niveau d’intégration sensori-motrice élevé. / As a result of a cerebrovascular accident (CVA), deficits in the controlateral and ipsilateral limb of the brain lesion are observed in person who had had a CVA. The performance of the ipsilateral limb is determined by the clinical severity of the contralateral limb and by the adequacy of bi-hemispheral processing of information. The objective of the present study is to compare the motor performance of the ipsilateral hand during tasks implying different level of sensori-motor integration in patients with low clinical impairments. The results demonstrated that the pinch strengths between the thumb and the index finger of the ipsilateral limb are modulated and anticipated adequately in stroke persons who have a good motor recovery such as demonstrated by scores of five or more in the Chedoke-McMaster Stroke Assessment (arm and hand parts). The motor performance of the ipsilateral limb of stroke persons during the execution of a bilateral coordination task is comparable to the motor performance of the dominant limb of healthy subjects when the task is realized without interaction between upper limbs (two objects) and it is perturbed when it implies a coordinated and reciprocal action of upper limbs on the same object. Consequently, these stroke persons with a good motor recovery have a central problem of integration and processing of sensori-motor informations when a more complex task has to be realized. These results suggest that the clinicians should pay more attention during unilateral tasks and during tasks with bilateral coordination that require a higher level of sensori-motor integration.

Made available in DSpace on 2016-12-06T17:06:58Z (GMT). No. of bitstreams: 1 Fabiano Braun de Moraes.pdf: 1084322 bytes, checksum: 27c8c8cac757f91e433fd9e084ba6016 (MD5) Previous issue date: 2014-05-26 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / The present study aimed to investigate the level of physical fitness of students from elementary school in Florianópolis. This research is characterized as descriptive, with the school population of males and females aged 9-12 years enrolled in the fourth and fifth years of elementary education in the public schools in Florianópolis, capital city from state of Santa Catarina. The sample selection was intentional and was conducted in 3 public schools, and data collection was performed in three steps. In the first step, the anthropometric data of 297 children (weight, height and BMI ) were assessed. In a second step, the research presents conducted a review of Physical Fitness, using such instruments as the tests that make up the MAFE Manual of Physical Evaluation in School that shows: Aerobic Capacity, Speed, Flexibility, Agility and the Strength of upper limbs and lower body. As a third step, psychosocial aspects related to the evaluation by means of a questionnaire answered by the students was held. In statistical analysis, it was used descriptive statistics, through the analysis of simple frequencies and percentages, analysis of variance and standard deviation, minimum, maximum and median values, using the statistical program EPINFO by analyzing the distributions of simple frequencies and percentage. The results showed that the physical fitness of schoolchildren have content similar to another regions of the country. The boys obtained values of physical fitness statistically superior to girls in all tests, except for the upper limb strength test, which were not identified differences in relation to gender. Concerning anthropometric measures, both boys and girls had a body mass index - BMI - average as being normal for the age group between 9-12 years. The psychosocial questionnaire was conducted to characterize the school. / O presente estudo teve como objetivo investigar o nível de aptidão física de escolares, do Ensino Fundamental 1, do município de Florianópolis. Esta pesquisa é caracterizada como descritiva, tendo como população os escolares dos sexos masculino e feminino, com idade entre 9 a 12 anos, matriculados no quarto e no quinto anos do Ensino Fundamental da rede pública de Florianópolis, Santa Catarina. A seleção da amostra foi do tipo intencional. A coleta de dados foi realizada em 3 escolas da rede pública, e em três etapas. Na primeira etapa, foram avaliados os dados antropométricos dos 297 escolares (peso, estatura e IMC). Em um segundo momento, foi realizada a avaliação da Aptidão Física, utilizando como instrumento de medida os testes que compõem o MAFE Manual de Avaliação Física Escolar: Capacidade Aeróbica, Velocidade, Flexibilidade, Agilidade, Força de Membros Inferiores e Superiores. Como terceira etapa, relacionado aos aspectos psicossociais, foi realizada a avaliação por meio de um formulário respondido pelos alunos. No tratamento estatístico, utilizou-se a estatística descritiva, mediante a análise das frequências simples e percentuais, análise de variância e desvio-padrão, valores mínimo, máximo e mediano, utilizando o programa estatístico EPINFO, mediante a análise das distribuições das frequências simples e percentuais. Os resultados obtidos demonstraram que os escolares pesquisados possuem índice de aptidão física semelhante aos de outras regiões do país. Os meninos obtiveram valores de aptidão física, estatisticamente superiores, às meninas em todos os testes, com exceção do teste de força de membros superiores, em que não se identificou diferença em relação ao gênero. Quanto às medidas antropométricas, tanto os meninos quanto as meninas obtiveram índice de massa corporal IMC médio normal para faixa etária entre 9 a 12 anos. O questionário psicossocial foi realizado para caracterização dos escolares.

We used RUSI (rehabilitative ultrasound imaging) for measurement of abdominal and back muscle in different loading modes. Methods: We used diagnostic ultrasonography imaging for taking linear measurement of trunk muscles. We measured anterioposterior (AP) dimensions of lateral abdominal wall muscles- m. OE, m.OI, m.TrA and cross-section area (CSA) of lumbar m. multifidus. We compared two groups of sports-floorball players and sportsman using climbing and hanging (climbers, aerialists). We measured positions with compressive force (kneeling on all four with lifted knees) and with traction load (hang with upper limbs with flexion of lower limbs-with leg support and without). Study is made on 50 volunteers. Results: The pattern of thickness of abdominal muscles is same in all positions in both groups. The lowest is always AP thickness of m. TrA, wider is m. OE and the widest always m. OI. The resting thickness are in both groups almost in all cases the lowest. AP thickness in m. TrA in floorball players is only exception, there is lowest in hang without legs support. In all other case sis resting position always lowest. For m. OE are results same for both climbers and floorball players-the lowest thickness is in hang with legs support (floorball players 0,84 cm, climbers 0,87), greater activationis...

Title: Evaluation criteria in running techniques in younger school age Objectives: The aim of this work is to perform the evaluation criteria in running technique in younger janitor age. In selected children I observed their technique of running in individual criteria. From the obtained data we will further find out how and in what the selected children improved. We will observe and assess individual criteria that will help us to the overall technique in the run. Methods: The experimental method of observation and measurement under artificially induced conditions was used. Results: I have found that children of younger school age can be significantly improved in the running technique for two months. In this period, children have great potential to learn new movements. I think that repeated specific running exercises help to improve the technique in running. Keywords: reflection, running step, vertical and horizontal movement of center of gravity, movement of upper limbs