Abstract  Background: Body composition is an important health parameter in several disease conditions, e.g., the inflammatory back disease spondylarthritis (SpA). Body mass index (BMI) is the most common anthropometric body composition assessment but has several limitations. As a result, several studies have been carried out to improve its validity by combining different body parameters. Nickerson equation (NE) is one of the equations developed to address the limitation of BMI. However, the knowledge is lacking on the preference of the NE which includes BMI (body weight and height), hand grip strength, and sex to estimate body fat percent over BMI alone among individuals with spondylarthritis. Aim: This study aims to assess the association between BMI and the Nickerson equation (NE) -estimate body fat percentage- with body composition measured with bioelectrical impedance assessment (BIA) and in individuals with spondylarthritis. Methods: Thirty-two individuals with SpA 17 women and 15 men with a median (range) age of 47 (30-66) years were included. The weight (kg), length (cm), hand grip strength (kg), and sex were registered to estimate values of body composition by the NE. BIA was equally used to assess total body fat %, visceral fat (cm2), and skeletal muscle mass (kg). Associations between the NE, or body mass index (BMI), and BIA were analyzed by Spearman’s correlations (rs). Results: The result shows that the NE has a rs of 0.6 to BIA total body fat higher than the BMI correlation coefficient of 0.3 but NE has a lower coefficient of 0.3 to visceral fat than the BMI which is 0.6, NE also has a negative correlation coefficient of 0.6 to skeletal muscles.  Conclusion: This study suggested that the Nickerson Equation which combines BMI, hand grip strength, and sex is a better assessment of body composition in individuals with spondylarthritis and encourages clinicians to consider using the Nickerson equation in clinical setting instead of BMI where access to precise assessment tools is unavailable.

Background  Maximum voluntary bite force (BF) and hand grip strength (HS) serve as muscle strength markers from the jaw motor system and hand motor system.   Aim  To investigate i) differences in maximum BF and HS between dominant and non-dominant sides, ii) differences between repeated tests in the same session and iii) correlation between BF and HS.     Methods Fifteen resistance trained adults (n=6 women, mean age 24 (SD 1.04) years and n=9 men, mean age 27 (SD 4.06) years) were tested with electronic BF and HS devices, with three repeated tests per side. Paired sample T-test was used to detect differences in BF and HS between sides and whether there was a difference between repeated tests. Pearson test was used to determine correlation between BF and HS. P-value <0.05 was considered statistically significant.    Results HS showed differences between dominant and non-dominant sides in three tests (T1 P=<0.0001, T2 P=0.0002 and T3 P=0.0011). BF showed differences between repeated tests in the same session for T1-T2 (P=0.007), T1-T3 (P<0.0001) and T2-T3 (P=0.028) on dominant side and between T1-T2 (P=0.014), T1-T3 (P=0.010) on non-dominant side. Correlation between BF and HS showed r=0.41 for merged data (dominant + non-dominant side) (P=0.02).   Conclusions  In the context of resistance trained adults, the findings showed that BF did not alter between sides while HS did, with higher force production for the dominant hand. Repeated tests showed differences between tests for BF, but not for HS. A weak to moderate correlation could be observed when comparing BF to HS.

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Work-related repetitive strain injury (RSI), one of the work-related musculoskeletal disorders, is the most commonly reported occupational illness, yet the pathophysiological mechanisms are not yet clear. Using our unique RSI animal model, pathophysiological tissue responses can be examined simultaneously with behavioral responses that serve as indicators of sensorimotor function. Studies in humans and with this animal model have shown that prolonged performance of repetitive tasks leads to declines in grip strength and increased of serum pro-inflammatory cytokines, both valuable biomarkers of underlying tissue injuries. Identification of biomarkers would help to elucidate the time course of the inflammatory stage of these disorders and disease progression. Sickness responses/behaviors, normal responses and behaviors occurring as a consequence of infection or illness, are responsible for re-organizing perceptions and actions to enable individuals to respond appropriately to the infection, injury and other illnesses. These behaviors can include malaise, fatigue, increased irritability and social withdrawal, behaviors that can be beneficial when ill for avoiding others and enhancing wellness. However, sickness behaviors can also include depression, sleep disorders and an enhanced perception of illness. Although recent studies have shown that circulating pro-inflammatory cytokines in serum may trigger sickness behaviors, only a few studies have examined if there is an association between work-related musculoskeletal disorders and subsets of sickness behavior; no one to date has elucidated any plausible biological cause of this association. Also, the combined effects of both aging and performance of repetitive tasks needs more evaluation since several epidemiological studies have shown a relationship between advancing age and susceptibility to musculoskeletal disorders. Therefore, using female Sprague-Dawley rats, the aims of this dissertation project are to: 1) To determine if a systemic inflammatory response is maintained long-term in rats exposed to a moderate demand lever-pulling task with high repetition, low force (HRLF) requirements; if aging enhances this systemic inflammatory response and if this response correlates with functional motor declines; 2) To determine if performance of repetitive upper extremity tasks leads to the development of sickness behaviors (weight loss, decreased social interaction and increased aggression); 3) To determine if a relationship between repetitive upper extremity tasks lead to the development of dose- and age-dependent sickness behaviors, and, to determine if increased serum or brain inflammatory cytokines are plausible mechanisms for the induction of sickness behaviors in this model; and, lastly, 4) To determine if prophylactic or secondary systemic treatments with anti-inflammatory drugs (anti--tumor necrosis factor alpha or ibuprofen) reduces sickness behaviors in rats performing a high demand high repetition high force (HRHF) reaching and handle pulling task. This finding would be in further support of an underlying task-induced inflammatory mechanism contributing to these sickness behaviors. In the first study, the relationship between serum and grip strength was examined in aged and young adult rats performing a HRLF task. Serum levels of interleukin 1-alpha (IL-1α), interferon-gamma (IFNγ) and IL-6 were higher in aged rats in general, compared to young adult rats. Each increased more in aged trained-only and 12-week HRLF rats than in young adult trained-only and 12-week HRLF rats. Serum IL-6 showed the greatest increases, with the highest levels observed in aged 12-week HRLF rats. Grip strength declined with task performance in both age groups; however, this decline correlated negatively and only moderately with serum IL-6 levels in aged rats. Thus, aging enhanced a serum cytokine response in general, a response that was even greater with repetitive task performance. Grip strength was adversely affected by task performance in both age groups, but was apparently influenced by factors other than serum cytokine levels in young rats. In the second study, the relationship between sickness behaviors (weight loss, duration of social interaction and aggression towards novel juvenile rats), serum cytokines and brain cytokines were examined in aged and young adult rats that trained to one of two task levels before performing a HRLF task. Decreased duration of social interaction and increased aggression was greater in both young adult and aged rats that trained for 10 min/day for 4-5 weeks to learn a high force (TRHF) task, compared to young adult and aged rats that learned a low force (TRLF) task. TRHF and TRLF rats of both age groups then performed a HRLF task for 6 to 24 weeks, rats termed TRHF-HRLF and TRLF-HRLF, respectively. Declines in social interaction resolved by week 3 in young adult TRHF-HRLF rats, but were still evident in 6-week aged TRHF-HRLF rats (the final endpoint for TRHF-HRLF rats). Significant increases in aggression were observed only in TRHF-HRLF rats, in both age groups. Declines in social interaction were also observed in aged rats performing a TRLF-HRLF task through week 9, but not in young adult TRLF-HRLF rats, even those performing the HRLF task for 24 weeks. These behaviors correlated moderately with increased serum IL-6 observed in the aged task rats (both TRHF-HRLF and TRLF-HRLF) and young adult TRHF-HRLF rats, although serum TNFalpha and IL-1beta also increased with task performance. Increased IL-6 and IL-6 receptor was detected immunohistochemically in brains of aged TRHF-HRLF rats, specifically in ependymal and endothelial cells, as well as glial cells and neurons of the anterior cingulate cortex and paraventricular nucleus. Thus, training to high force, even for a short time period, induced increased sickness behaviors. Aging contributed to increased sickness behaviors in repetitive task rats, and to increased expression of IL6 and IL-6 receptor in several brain regions. In the third study, the relationships between sickness behaviors (duration of social interaction and aggression towards novel juvenile rats), serum cytokines and brain cytokines were examined in young adult rats performing a high repetition high force (HRHF) task with or without anti-inflammatory medications. Rats that trained to high force (TRHF) had decreased duration of social interaction and increased aggression; these behaviors were prevented by prophylactic anti-TNFalpha or ibuprofen treatment. Untreated TRHF rats that went on to perform a HRHF task showed decreased social interaction and increased aggression through week 12; these behaviors were attenuated by secondary anti-TNFalpha and ibuprofen treatments. Untreated HRHF rats had increased serum GroKC, IFN-gamma, IL-1beta, MIP2, MIP3a and TNFalpha. These increases were attenuated after two weeks of anti-TNFalpha treatment in HRHF weeks 5-6, and after 8 weeks of ibuprofen (in HRHF weeks 5-12). The sickness behaviors correlated moderately with increased serum Gro-KC, MIP2 and TNFalpha, and were concomitant with increased IL-1beta immunoexpression in ependymal and endothelial cells in brains of untreated TRHF and HRHF rats. Both treatments reduced the increased brain IL-1beta expression. Thus, sickness behaviors induced by overuse are attenuated by anti-inflammatory interventions that reduce task-induced increases in systemic and brain inflammatory cytokines. In conclusion, both aging and task performance increased serum inflammatory cytokine responses, the latter in an exposure-dependent manner, with a greater serum cytokine response with performance of high force tasks than low force tasks. While grip strength was adversely affected by task performance in both young and aged rats, it was influenced by factors other than serum cytokine levels. In contrast, decreased duration of social interaction and increased incidence of aggression were influenced by task-induced increases in serum and brain inflammatory cytokines, responses attenuated to baseline levels with systemic anti-inflammatory treatments. Sickness behaviors were also dose- and age-dependent, with higher incidence with performance of high force tasks than with low force tasks, and higher incidence in aged rats. We postulate that the higher incidence in aged rats is due to aged-induced brain "inflamm-aging", as they also had increased immunoexpression of IL6 and IL6 receptor in blood brain barrier cells and in glial and neurons of the hypothalamic pituitary axis. / Physical Therapy

This investigation was conducted to explore the between trial variability of the measures of the isometric peak force, time to peak force, area to peak force, area under the curve, slope (20%-80%), and the average slope of subjects assigned to perform a series of four isometric grip strength contractions and to develop a discriminant function equation that would predict group membership. Forty-nine college students were instructed to perform either a series of four maximal voluntary contractions (sincere) or a series of four submaximal (deceptive) contractions. The subjects were retested 24-48 hours after the initial test session. Data from both test sessions were recorded, displayed, and analyzed using segmental curve analysis. The coefficients of variation were computed for each test variable. The grand mean coefficient of variation for the sincere condition was .31 ± .02 compared to the grand mean coefficient of variation for the deceptive condition which was .77 ± .11 (p < .01). Coefficients of variation were used to predict group membership. The prediction equation accurately classified 92% of the sincere condition and 64% of the deceptive condition. / Master of Science

The primary, descriptive aim of this dissertation was to describe the nighttime sleep quality of previously mechanically ventilated older adult patients within 24-48 hours of transfer out of the intensive care unit (ICU) to a medical-surgical floor. The secondary, exploratory aim was to examine the relationships between post-ICU sleep efficiency (SE) and wake after sleep onset (WASO) with grip strength in previously mechanically ventilated older adult patients within 24-48 hours of transfer out of the ICU. The study included 30 adults ages 65 and older (11 women, 19 men; age 71.37 ± 5.35, range 65-86 years), who were functionally independent at home prior to hospitalization, mechanically ventilated during their ICU stay, and were within 24-48 hours of transfer out of ICU to a medical-surgical floor at Tampa General Hospital, a level 1 trauma center. Subjects wore an actigraph monitor on the dominant wrist (Actiwatch Spectrum) to monitor sleep over two consecutive nights. Parameters of post-ICU sleep quality included total sleep time (TST), sleep efficiency (SE), wake after sleep onset (WASO), sleep latency (SL), and number of awakenings (NA). The outcome measure of motor function was dominant hand grip strength, assessed by the National Institutes of Health Toolbox Motor Battery Grip Strength Test. Sleep data collected between nighttime hours (9:00 PM to 9:00 AM) on both nights were analyzed. For the descriptive aim, means for each sleep parameter and clinical characteristics were reported. For the exploratory aims, multiple regression analyses examined the individual associations between mean sleep parameters (SE and WASO) and grip strength. Study subjects had a mean SE of 63.24 ± 3.88% and spent 135.39 ± 9.94 minutes awake after sleep onset. The mean TST among subjects was 7.55 ± 2.52 hours, ranging from 2.02 to 10.84 hours of sleep, out of the 12 hours of total time in bed. A total of 6 (20%) subjects slept less than 5 hours each night, and a total of 6 (20%) subjects slept greater than 10 hours each night. The mean SL among study subjects was 42.57 minutes, and ranged from 0.0 to 237.75 minutes. Overall, subjects’ average NA was 78.28 ± 26.39, ranging from 35 to 136 awakenings. In multiple regression analysis, SE was significantly and negatively associated with grip strength, after adjusting for potential confounding factors. The model predictors explained 80.8% of the variance in grip strength, [R2 = .808, F(10, 15) = 6.324, p = .001]. Higher SE independently predicted worse grip strength (β = -0.326, p = .036). Further, among the tertiles of subjects with moderate or high TST (sleep duration ≥ 6 hours, n = 23), there remained a significant, negative association between SE and grip strength. The predictors explained 73.7% of the variance in grip strength, [R2 = .737, F(5, 15) = 8.416, p = .001]. Higher SE independently predicted worse grip strength among the subset of subjects with moderate or high sleep duration (β = -0.296, p = .046). Among the two quartiles of subjects with moderate-high or high WASO (≥ 120 minutes spent awake after sleep onset, n = 16), there was a significant, negative association between WASO and grip strength, after adjusting for covariates. The model indicated that the predictors explained 91.4% of the variance in grip strength [R2 = .914, F(6, 8) = 14.134, p = .001]. Greater WASO independently predicted worse grip strength (β = -0.276, p = .04). Finally, the effects of sex and preexisting obstructive sleep apnea (OSA) on grip strength were individually examined. Higher SE independently predicted worse grip strength among male subjects (β = -0.353, p = .039), as did preexisting OSA (β = -0.493, p = .033). In summary, objectively measured sleep quality was disturbed among previously mechanically ventilated, hospitalized older adults, even after transfer out of ICU to a medical-surgical floor. Longer TST and greater SE predicted worse grip strength among these frail patients who were previously independent, community dwelling older adults. Among the subjects with more severely fragmented sleep, WASO also independently predicted weaker grip strength. As poor grip strength is an indicator of ICU-acquired weakness, optimal sleep duration and less sleep disturbances may be crucial in prevention of worse functional outcomes and new institutionalization. Additional research is needed to discern the temporality of associations between sleep quality and motor function among older adult survivors of critical illness.

?rea de concentra??o: Aspectos f?sico-funcionais e reabilita??o. / Na Capa da obra consta o t?tulo: "Vibra??o de corpo inteiro na posi??o est?tica com as m?os sobre a plataforma estimula o sistema neuromuscular potencializando a for?a muscular de preens?o manual". / Submitted by Jos? Henrique Henrique (jose.neves@ufvjm.edu.br) on 2018-05-24T01:30:29Z No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) ana_lucia_cristino_souza.pdf: 1341281 bytes, checksum: 26bbfcfe249430241b08885a752b2dac (MD5) / Approved for entry into archive by Rodrigo Martins Cruz (rodrigo.cruz@ufvjm.edu.br) on 2018-06-05T14:42:35Z (GMT) No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) ana_lucia_cristino_souza.pdf: 1341281 bytes, checksum: 26bbfcfe249430241b08885a752b2dac (MD5) / Made available in DSpace on 2018-06-05T14:42:35Z (GMT). No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) ana_lucia_cristino_souza.pdf: 1341281 bytes, checksum: 26bbfcfe249430241b08885a752b2dac (MD5) Previous issue date: 2017 / A vibra??o do corpo inteiro (VCI) pode ser uma modalidade ergog?nica capaz de melhorar o desempenho muscular. Uma vez que a transmissibilidade deste est?mulo ? reduzida quando aplicado sob os p?s, permanece uma lacuna no que tange a potencializa??o da for?a de preens?o manual (FPM) na posi??o est?tica, com as m?os sobre a plataforma, em indiv?duos saud?veis. O objetivo deste estudo foi investigar o efeito dose-resposta da exposi??o ? vibra??o na posi??o est?tica, com as m?os sobre a plataforma na FPM e nos registros eletromiogr?ficos (EMG) do m?sculo flexor superficial dos dedos. Vinte e oito mulheres saud?veis (idade: 27 + 8 anos, IMC: 23,2 + 4,5 kg.m-2) foram familiarizadas e submetidas de forma randomizada e aleatorizada a quatro situa??es experimentais: A). Sentado - m?os supinadas, apoiadas nas pernas, sem est?mulo vibrat?rio; B) Placebo ? m?os posicionadas sobre a plataforma desligada e est?mulo sonoro mimetizando o est?mulo de vibra??o; C). 25Hz / 2mm e D). 45Hz / 2mm - semelhante ? posi??o placebo com est?mulo vibrat?rio vertical sinusoidal em diferentes freq??ncias, com aplica??o da amplitude de 2mm. O per?odo de interven??o foi de 5 minutos em todas as situa??es experimentais. Antes e imediatamente ap?s as interven??es, o desempenho muscular da m?o dominante foi avaliado usando o dinam?metro de for?a manual (Jamar, EUA). Os registros EMG (Miotec, Brasil) ocorreram durante as situa??es experimentais. A raz?o neuronal representou a rela??o entre registros EMG e for?a de preens?o. A an?lise estat?stica foi realizada por ANOVA bifatorial, com post hoc (Tukey), sendo considerado p <0,05 significativo. Como resultado, a exposi??o ? vibra??o de 45Hz / 2mm resultou em um aumento de varia??o (p?s-antes) na FPM em m?dia de 84,6%, 93,7%, 62,6% para controle, placebo e 25Hz / 2mm, respectivamente. Este aumento foi acompanhado por uma menor rela??o neuronal. Os registros EMG durante o per?odo de interven??o demonstraram que apenas a exposi??o ao VCI (45Hz / 2mm) aumentou os registros EMG em uma m?dia de 94,8 % e 50,2% em rela??o ao controle e placebo, respectivamente. Esses achados mostram que a exposi??o ? vibra??o na posi??o push-up modificada est?tica potencializou a resposta miog?nica da m?o de forma dose dependente. O mecanismo parece estar relacionado com a estimula??o do sistema neuromuscular e a subsequente potencia??o p?s-ativa??o que defende o aprimoramento neural. / Disserta??o (Mestrado Profissional) ? Programa de P?s-Gradua??o em Reabilita??o e Desempenho Funcional, Universidade Federal dos Vales do Jequitinhonha e Mucuri, 2017. / Because the transmissibility of vibration is lower when applied under the feet, an uncertainty remains as to whether this stimulus could potentiate handgrip strength (HS) in the static modified push-up position. The aim of this study was to investigate the effect of vibration in the push-up position on HS and electromyography (EMG) of the superficial flexor muscle of the fingers. 28 healthy women (age: 27 + 8 years, BMI: 23.2 + 4.5 kg.m-2) were familiarized and submitted, to four experimental situations in a balanced, and randomized order: A). Seated supine with hands supported on the legs; B) Placebo ? hands on the platform off; C). 25 Hz/2 mm/49.30 m.s-2 and, D). 45 Hz/2 mm/159.73 m.s-2 similar to the placebo position with vibration turned on. The intervention was 5-minutes in all experimental situations. Muscle performance was evaluated using the HS dynamometer (Jamar, USA). The EMG (Miotec, Brazil) was registered throughout experimental situations. The neuronal ratio represented the ratio between EMG and HS. The 45 Hz exposure resulted in an increase in variation of the HS by 84.6%, 93.7%, 62.6% relative to the control, placebo and 25 Hz, respectively. This augment was accompanied by a lower neuronal ratio. The EMG during the intervention demonstrated that only 45 Hz increased the EMG by an average of 94.8%, and 50.2% compared to the control and placebo, respectively. In conclusion, the vibration in the push-up position potentiated the HS. The mechanism seems to be related to the stimulation of the neuromuscular system and subsequent post-activation potentiation advocating neural enhancement.

Submitted by Izabel Franco (izabel-franco@ufscar.br) on 2016-09-27T20:00:37Z No. of bitstreams: 1 DissLGPS.pdf: 4152962 bytes, checksum: 26969eebd1edf77d30082f3ae4839500 (MD5) / Approved for entry into archive by Ronildo Prado (ronisp@ufscar.br) on 2016-09-30T20:33:40Z (GMT) No. of bitstreams: 1 DissLGPS.pdf: 4152962 bytes, checksum: 26969eebd1edf77d30082f3ae4839500 (MD5) / Approved for entry into archive by Ronildo Prado (ronisp@ufscar.br) on 2016-09-30T20:33:49Z (GMT) No. of bitstreams: 1 DissLGPS.pdf: 4152962 bytes, checksum: 26969eebd1edf77d30082f3ae4839500 (MD5) / Made available in DSpace on 2016-09-30T20:39:34Z (GMT). No. of bitstreams: 1 DissLGPS.pdf: 4152962 bytes, checksum: 26969eebd1edf77d30082f3ae4839500 (MD5) Previous issue date: 2015-02-27 / Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) / The grasp is recognized as a useful tool to identify the level of development and the degree of disability of an individual on clinical practice; however the data available in the literature about the maximum grip strength in children and adolescents should be periodically extended. In addition, there is no quantitative researches on literature about the pattern of development grasp of typical children. Objective: To characterize the handgrip of typical children aged between 5 and 10 years. Methods: The project was divided into two studies. On study 1, healthy children, aged between 5 and 10 years were divided into six groups according to age. Participants were subjected to a single assessment to obtain the anthropometry data (height and weight) and grip strength data (maximum grip strength). On study 2, a device was developed to characterize, both qualitatively and quantitatively, the standard grip for the task of drinking water. To test the device, they were randomly selected 16 participants from the study 1. Results:(Study 1) Significant increase in maximum grip strength throughout the ages was observed. The boys were stronger than girls. The dominant hand was stronger than the non-dominant hand for both genders. For girls, there was a strong correlation between maximum grip strength with the hand length and body mass. For boys, therewas a strong correlation with the length of the hand and height. (Study 2) The grip pattern data were measured using a device whose shape was made to a similarly transparent glass. Final Considerations: This study provides reference values for maximum grip strength of children aged between 5 and 10 years. The maximum grip strength increases throughout the ages. The boys are stronger than girls, regardless of age and tested hand. In addition, it was developed a prototype device that ultimately could providea detailed evaluation of the strategies used in the handgrip for a functional task. Thus expanding the understanding of the mechanisms related to modulation of grip when handling objects will assist in identifying the pathogenesis of motor disorders in children with developmental disorders without the values are underestimated by the expected for their age. / Embora seja reconhecida a importância clínica da preensão como ferramenta útil para identificar o nível de desenvolvimento e o grau de deficiência de um indivíduo, os dados disponíveis na literatura quanto à força de preensão palmar máxima em crianças e adolescentes devem ser periodicamente ampliados. Além disso, não há na literaturaestudos quantitativos sobre o desenvolvimento do padrão de preensão de crianças típicas em idade escolar. Objetivo: Caracterizar a preensão de crianças típicas com idade entre 5 e 10 anos. Métodos:O projeto foicomposto por dois estudos. No estudo 1, participaram criançassaudáveis, com idade entre 5 e 10 anos, divididas em seis grupos, de acordo com a faixa etária. Os participantes foram submetidosa uma única avaliação, na qual foram obtidosos dados referentes à antropometria (estatura e massa corporal) e dinamometria (força de preensão palmar máxima). No estudo 2, foi desenvolvido um dispositivo que caracterizaqualitativa e quantitativamente, o padrão da preensão durante a tarefa de beber água. Para testar o dispositivo, foram selecionados aleatoriamente (sorteio) 16 participantes do Estudo 1. Resultados: (Estudo 1) Foi observado aumento significativo da força de preensão palmar máxima ao longo das idades. Os meninos foram mais fortes do que as meninas. A mão dominante foi mais forte do que a não dominante para ambos os gêneros. Para as meninas, houve forte correlação da força de preensão palmar máxima com o comprimento da mão e a massa corporal. Para os meninos, houve forte correlação com o comprimento da mão e a estatura. (Estudo 2)Os dados referentes ao padrão de preensão palmar foram aferidos por meio de um dispositivo, cujo formato foi confeccionado similarmente a um copo transparente. Considerações Finais: Este estudo fornece valores de referênciada força de preensão palmar máximade crianças com idade entre 5 e 10 anos. A força de preensão palmar máxima aumenta ao longo das idades. Os meninos são mais fortes do que as meninas, independente da idade e da mão testada. Além disso, foi desenvolvido o protótipo de um dispositivo que futuramente poderá fornecer uma avaliação detalhada das estratégias utilizadas na preensão manual durante uma tarefa funcional.Assim, a ampliação do entendimento dos mecanismos relacionados à modulação da preensão duranteamanipulação deobjetosauxiliará na identificação da patogenia das alterações motoras de crianças com distúrbios do desenvolvimento sem que os valores obtidos sejam subestimados pelo esperado para a sua idade.

Made available in DSpace on 2016-12-06T17:07:29Z (GMT). No. of bitstreams: 1 Rodrigo Knabben.pdf: 1171074 bytes, checksum: b9e985c555d50dc6327acd4fa0a00810 (MD5) Previous issue date: 2011-03-02 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / This study aimed to measure motor skills and functional upper limb (UL) in the acute phase and three months after stroke, to identify and observe the relationship of residual deficits (RD) rating in each of these variables as well as the gain between the two periods in patients with mild motor / moderate and severe MS in the acute phase. We evaluated 29 subjects (17 severe and 12 mild / moderate) adults (63.7 ± 14.3 years) of both sexes with squealed of hemiplegia / hemiparesis due to stroke in the acute phase (9.3 ± 3.4 days post-stroke) and three months after injury. In the evaluations were measured evolutions of the motor variables (spasticity - Modified Ashworth Scale, degree of motor and somatosensory deficits - Fugl-Meyer Scale-UL; grip strength - Chatannoga® hand dynamometer, digital dexterity - Nine Hole Peg Test / NHPT ) and the functional variable (level of independence in self-care - FIM). To examine and compare the motor deficit, the grip strength, dexterity and functional independence between the acute phase and 3 months in every group and sub-groups of patients severe and mild / moderate, we used the Wilcoxon test. For comparison between subgroups, we used the Mann-Whitney. The measurement of the strength of association between: a handgrip strength (mean of maximum force) and digital dexterity with the levels of motor deficit, level of independence in self-care, we used the Spearman correlation. To investigate the differences between the variables (motor impairment, grip strength and digital dexterity) in acute and sub-acute, we used the Student t-test. The highest correlation was with the RD force motor deficit in both the acute phase and at three months (&#961; = 0.91 and 0.82 respectively) and the RD of digital dexterity was with the functional independence in self-care in acute and the motor deficit at three months (&#961; = 0.72 and 0.78 respectively). The correlation between the RD strength and digital dexterity were higher at three months (&#961; = 0.75) than the acute phase (&#961; = 0.70). The knowledge of grip strength and dexterity in the first months after stroke may bring relevant information for planning of clinical practice and rehabilitation of upper limb aimed at the patient's functional independence. / Esta pesquisa teve o objetivo de mensurar variáveis motoras e funcionais do membro superior (MS) na fase aguda e nos três meses após um Acidente Vascular Encefálico (AVE), visando identificar e observar a relação dos déficits residuais (DR) destas variáveis em cada avaliação, assim como o ganho entre os dois períodos em pacientes com comprometimento motor leve/moderado e severo no MS na fase aguda. Foram avaliados 29 indivíduos (17 severos e 12 leve/moderados) adultos (63,7±14,3 anos) de ambos os sexos com seqüela de hemiplegia/hemiparesia devido ao AVE na fase de aguda (9,3±3,4 dias pós-AVE) e nos três meses após a lesão. Nas avaliações foram medidas as evoluções das variáveis motoras (espasticidade - Escala de Ashworth modificada; grau de déficit motor e somatossensorial - Escala de Fugl-Meyer-MS; força de preensão - dinamômetro manual Chatannoga®, destreza digital - Nine Hole Peg Test/NHPT) e da variável funcional (nível de independência nos auto-cuidados - MIF). Para verificar e comparar o déficit motor, a força de preensão manual, a destreza e a independência funcional entre a fase aguda e 3 meses em todo grupo e nos sub-grupos de pacientes severo e leve/moderado foi utilizado o Teste de Wilcoxon. Para a comparação entre sub-grupos, foi utilizado o Teste de Mann-Whitney. A mensuração da força da associação entre: a força de preensão manual (média da força máxima) e destreza digital com os níveis do déficit motor, e nível de independência nos auto-cuidados utilizou-se a correlação de Spearman. Para investigação das diferenças entre as variáveis estudadas (déficit motor, força de preensão e destreza digital) na fase aguda e sub-aguda, foi utilizado o teste-t de Student. As maiores correlações do DR força foi com déficit motor tanto na fase aguda como aos três meses (&#961;=0,91 e 0,82 respectivamente) e do DR da destreza digital foi com a independência funcional nos auto-cuidados na fase aguda e com o déficit motor aos três meses (&#961;=0,72 e 0,78 respectivamente). A correlação entre o DR da força e destreza digital apresentou-se maior aos três meses (&#961;=0,75) em comparação a fase aguda (&#961;=0,70). O conhecimento da evolução da força de preensão e destreza nos primeiros meses após o AVE poderá trazer informações relevantes para o planejamento da prática clínica e a reabilitação do membro superior parético visando a independência funcional do paciente.