Le but de ce travail est de déterminer les liens éventuels existant entre la force et l’équilibre agoniste / antagoniste des muscles rotateurs médiaux et latéraux de l’articulation scapulohumérale, et la stabilité scapulo-humérale. La première partie de ce travail est un rappel d’anatomie fonctionnelle, de physiologie articulaire et de biomécanique de l’articulation scapulo-humérale, ainsi que des aspects pathologiques en rapport avec la problématique de sa stabilité et de son exploration. La deuxième partie propose une analyse critique de la technique d’exploration de la force musculaire par dynamométrie isocinétique, afin de déterminer un protocole d’évaluation fiable et reproductible. Ainsi, nous choisissons d’utiliser la position d’évaluation la plus reproductible et la plus adaptée pour l’évaluation de sujets pathologiques : la position assise avec 45° d’abduction dans le plan de la scapula avec correction de la gravité. La troisième partie a pour objet de rechercher, à partir d’études cliniques originales, les liens existant entre la force musculaire des rotateurs médiaux et latéraux de l’épaule et l’instabilité antérieure chronique post-traumatique d’une part, et les adaptations de cette force avec certaines sollicitations sportives d’autre part. Bien qu’un déficit de la force musculaire des rotateurs médiaux et latéraux soit associé à l’instabilité antérieure chronique, nos études ne rapportent pas d’association entre le déséquilibre agoniste/antagoniste et l’instabilité antérieure chronique. Dans le cadre de la pratique de sports sollicitant les membres supérieurs, les adaptations de la force, avec une augmentation de la force des muscles rotateurs médiaux et latéraux du côté dominant, sont inconstantes, et surtout, nos résultats ne rapportent aucun déséquilibre agoniste/antagoniste induit par la pratique sportive. En conclusion, notre travail de thèse met en évidence des adaptations de la force musculaire sans perturbation de l’équilibre agoniste/antagoniste des rotateurs médiaux et latéraux de l’articulation scapulo-humérale, associées à l’instabilité scapulo-humérale ou induites par la pratique de sports sollicitant cette articulation. Prenant en compte les limites de notre expérimentation, on peut faire l’hypothèse que les adaptations physiologiques induites par la pratique sportive n’interviendraient pas comme un mécanisme de désadaptation, ou un facteur de risque prédisposant, à l’origine des pathologies de l’articulation scapulo-humérale. Ainsi, notre conclusion serait que l’équilibre agoniste / antagoniste aurait un rôle protecteur de la stabilité articulaire ; la survenue d’un déséquilibre musculaire agoniste / antagoniste serait alors secondaire à une lésion anatomique et marquerait le signe de son évolution longue et/ou péjorative / The aim of this work is to determine the possible links between strength and agonist/antagonist balance of the shoulder internal and external rotators muscle, and the glenohumeral stability. The first part of this work is a reminder of functional anatomy, joint physiology and biomechanics of the glenohumeral joint, and pathological aspects related to the problem of its stability and its exploration. The second part propose a critical analysis of technical exploration of muscular strength by isokinetic dynamometer to determine a reliable and reproducible protocol. We choose to use the more reliable and more suitable position for evaluation of pathological subject: the seated position with 45° of shoulder abduction in the scapular plane, with gravity corrected. The third part is aimed to research, from original clinical studies, the relationship between shoulder internal and external rotators muscle strength and balance, and shoulder instability on the one hand, and adaptations of this strength with sports practice on the other hand. Although a deficit in rotators muscle strength is associated with recurrent anterior instability, our work reporte no association between agonist/antagonist imbalance and recurrent anterior instability. In overhead sports and sports seeking the upper limbs, adaptations of strength, with a rotator strength increase on the dominant side, are inconsistent, and most importantly, our results reporte no agonist/antagonist imbalance induced by the sports practice. In conclusion, this work highlights adaptations in strength and balance of the shoulder internal and external rotators muscle associated with the glenohumeral joint instability, or induced by the sports practice. Tacking into account the limits of our experiment, we can hypothesis that any physiological adaptations induced by sport practice would not intervene as a pathophysiological mechanisms of desadaptation, or not be considered a risk factor predisposing, to glenohumeral joint diseases. Thus, our conclusion is that the agonist/antagonist balance would have a protective role of the joint stability; the occurrence of a muscle agonist / antagonist imbalance may be secondary to an anatomical lesion and mark the sign of its long and/or pejorative evolution

As quedas estão entre as principais causas de morbimortalidade em indivíduos idosos. Devido a sua natureza multifatorial, a identificação do risco para quedas acaba se tornando uma tarefa complexa. Testes físico-funcionais, em especial aqueles que envolvem força muscular e equilíbrio, tem se mostrado como preditores independentes para eventos futuros. Por outro lado, a utilização destes testes isoladamente pode não ser suficiente na identificação do risco para quedas de idosos com bom desempenho físico e sem limitações aparentes. Sendo assim, considerar múltiplos fatores de risco para quedas na avaliação de idosos pode trazer informações importantes para o desenvolvimentos de programas preventivos. Objetivo: analisar a influência dos fatores de risco para quedas no desempenho físico-funcional e no desempenho cognitivo de idosos da comunidade. Métodos: A amostra foi constituída de 112 idosos (60 anos) de ambos os sexos, regularmente inscritos na Universidade Aberta à Terceira Idade (UnATI) da Escola de Artes, Ciências e Humanidades da USP. Os idosos foram submetidos a questionários estruturados sobre dados sociodemográfico, condições de saúde e histórico de quedas, a testes de rastreio cognitivo (mini-exame do estado mental, MEEM) e depressão (escala de depressão geriátrica) e testes físico-funcionais, incluindo avaliação da força de preensão palmar (hand grip, HG) da força de membros inferiores (sentar e levantar da cadeira de 5 repetições, SLC) e da mobilidade (Timed-up and Go, TUG). Após as avaliações, os idosos foram divididos em três grupos, de acordo com a presença de fatores de risco conhecidos para quedas: 1) BAIXO risco (n=22): idosos sem ou com um fator, 2) MODERADO risco (n=59): idosos com dois ou três fatores e 3) ALTO risco (n=31): idosos com quatro ou mais fatores. Para todas as análises, o nível de significância adotado foi de p<0,05. Resultados: Os fatores de riscos para quedas mais prevalentes na amostra total foram: sexo feminino (83,6%), redução da força muscular (63,1%), sedentarismo (35,1%) e histórico de quedas (27,9%). Na comparação entre os grupos, foi constatada maior prevalência de histórico de quedas e de mulheres nos grupos com mais fatores de risco. O grupo ALTO risco apresentou pior desempenho nos testes físico-funcionais e no MEEM comparativamente aos demais grupos, além de pontuar dentro da nota de corte de risco para quedas no teste SLC (ou seja, >12 seg) e no MEEM (ou seja, <25 pontos). Comparado ao grupo BAIXO risco, a probabilidade dos idosos do grupo ALTO risco terem pior desempenho no TUG, no SLC, no HG e no MEEM foi respectivamente de 70, 83, 82 e 68%. Conclusão: o grupo ALTO risco apresentou pior desempenho nos testes físico-funcionais e no MEEM, comparativamente com os demais grupos. Além disso, foi observada influência negativa do número de fatores de risco para quedas sobre o desempenho físico-funcional e cognitivo dos idosos. A avaliação de múltiplos fatores de risco para quedas pode trazer informações importantes para o desenvolvimento de programas de prevenção de quedas dentro das UnATIs / Falls are among the main causes of morbimortality in old individuals. Due to its multifactorial nature, identifying the risk of falls becomes a complex task. Physical-functional tests, especially those involving muscle strength and balance, have been shown to be independent predictors for future events. On the other hand, the use of these tests alone may not be enough to identify the risk for falls of older people with good physical performance and without apparent limitations. Therefore, considering multiple risk factors for falls in the evaluation of older adults can bring important information for the development of preventive programs. Objective: to analyze the influence of risk factors for falls in the physical-functional and cognitive performance of community-dwelling older adults. Methods: The sample consisted of 112 older adults (60 years) from both sexes, regularly assigned in the Open University of the Third Age (U3A) of the School of Arts, Sciences and Humanities of USP. Older adults were submitted to structured questionnaires about socio-demographic data, health conditions and fall history, cognitive screening (Mini-mental State Examination, MMSE), depression (Geriatric Depression Scale) and physical-functional tests, including assessment of handgrip strength (Hand Grip, HG), lower limb strength (5-repetitions sit to stand, STS) and mobility (Timed-up and Go, TUG). After the evaluations, older adults were divided into three groups, according to the presence of well-known risk factors for falls: 1) LOW-risk (n = 22): older adults with or without a factor, 2) MODERATE-risk (n = 59 ): older adults with two or three factors and 3) HIGH-risk (n = 31): older adults with four or more factors. Level of significance was set at p<0.05 to all analysis. Results: the prevalence of risk factors for fall in the total sample were: women (83.6%), reduction of muscular strength (63.1%), sedentary lifestyle (35.1%) and any fall history (27.9%). Higher prevalence of history of falls and of women were observed in the HIGH-risk compared to the others groups. The HIGH-risk group presented worse performance in the physical-functional tests and in the MMSE compared to the other groups, besides scoring within the cut-off for falls in SLC (ie, > 12 sec) and MMSE (ie, <25 points). Compared to the LOW-risk group, the probability of older adults from HIGH-risk group had a worse performance on TUG, STS, HG and MMSE were 70, 83, 82 and 68%, respectively. Conclusion: the HIGH-risk group presented worse performance in the physical-functional tests and the MMSE, in comparison with the other groups. In addition, a negative influence of the number of risk factors for falls on the physical-functional and cognitive performance of the older adults was observed. The assessment of multiple risk factors for falls can bring important information for the development of fall prevention programs in the U3As

Soccer players change direction repeatedly throughout a game, making agility an important component of their performance. The purpose of this project was to identify how anatomical and physical characteristics influence agility performance among soccer players. The influences of anthropometry, strength, and power on agility performance in soccer players were investigated. The participants were NCAA Division I soccer players (N = 65). Anthropometric measures included height, body mass, percent body fat, lean body mass. Strength was evaluated using an isometric mid-thigh pull, and power was measured by vertical jumps. In correlation analysis, agility performance showed a statistically significant correlation (p<0.05) with peak power (PP) from 0kg and 20kg counter-movement jumps (r=-.379 & r=-.364 respectively) for the male players. Also for the males, percent body fat showed significant correlations (p<0.05) with Average 2 (r=-.438), 3 (r=-.411), and All (r=-.436). I conclude that the anthropometric measures evaluated have little influence on agility performance.

This review discusses previous literature that has examined the influence of muscular strength on various factors associated with athletic performance and the benefits of achieving greater muscular strength. Greater muscular strength is strongly associated with improved force-time characteristics that contribute to an athlete’s overall performance. Much research supports the notion that greater muscular strength can enhance the ability to perform general sport skills such as jumping, sprinting, and change of direction tasks. Further research indicates that stronger athletes produce superior performances during sport specific tasks. Greater muscular strength allows an individual to potentiate earlier and to a greater extent, but also decreases the risk of injury. Sport scientists and practitioners may monitor an individual’s strength characteristics using isometric, dynamic, and reactive strength tests and variables. Relative strength may be classified into strength deficit, strength association, or strength reserve phases. The phase an individual falls into may directly affect their level of performance or training emphasis. Based on the extant literature, it appears that there may be no substitute for greater muscular strength when it comes to improving an individual’s performance across a wide range of both general and sport specific skills while simultaneously reducing their risk of injury when performing these skills. Therefore, sport scientists and practitioners should implement long-term training strategies that promote the greatest muscular strength within the required context of each sport/event. Future research should examine how force-time characteristics, general and specific sport skills, potentiation ability, and injury rates change as individuals transition from certain standards or the suggested phases of strength to another.

[Truncated abstract] Resistance training is increasingly popular for improving strength qualities such as hypertrophy, maximal strength, endurance and power. Although many resistancetraining programmes now adhere to the concept of periodisation, the number of studies examining its structure and design are few, and there are just a handful of studies that have examined periodised training for the maintenance of strength and power. Even rarer, are periodised resistance-training studies that utilise female subjects. Previous studies have compared non-periodised training regimens such as Progressive Resistance Exercise (PRE), and the two main models of periodisation, Linear Periodisation (LP) and Undulating Periodisation (UP). Results are inconclusive as to whether the efficacy of the periodised training programmes were due to the manipulation of training variables such as volume and intensity, or that training programmes with higher doses of volume induced better training responses. However, to make effective comparisons between training programmes, the training volume or workload (total load lifted x total repetitions) and training intensity have to be equated between the groups under examination. While the intensities (percentage of one-repetition maximum, 1 RM) for improving strength qualities such as hypertrophy and maximal strength have general consensus among resistance-training practitioners, there exists disagreement over the intensity that should be used during the training of power. Thus, it is important to first identify the load for power training before comparisons can be made between LP and UP programmes using equal training volumes. ... The final study found that adhering to two UP maintenance training programmes with equalised volumes and intensities twice a week increased upper-body strength and maintained lower-body strength adequately across a 3-wk phase. The results from these studies support previous results that suggest training programmes with higher workloads and repetitions produce superior strength and power adaptations, and it is not specifically the variation of training volume and intensity within a periodised programme that improves strength qualities. Thus, both periodised programmes used in this thesis can be recommended for untrained and moderatelytrained women as both LP and UP were found to be similarly effective for increasing upper- and lower-body hypertrophy, strength and power.

Made available in DSpace on 2016-12-06T17:07:24Z (GMT). No. of bitstreams: 1 Wladymir.pdf: 332547 bytes, checksum: d4a416081f3ac8f18d5af877b9ed36d6 (MD5) Previous issue date: 2010-03-02 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / In general, the body size appears to represent a factor that affects the performance in physical tests and also in daily activities, in a manner that taller and heavier individuals are generally stronger than shorter and lighter ones. The relation between the body mass (BM) and the muscular power also seems to obey the power law (Y=Y0*BMb), where the allometric modeling may serve as a practical and useful tool for the equal comparison of individuals with different body mass. The objective of the present work was to verify the suitability of the allometric scaling in the comparison of the performance obtained by individuals who practice resistence exercise (RE). The sample was composed by 11 men and 11 women non athletes, who practice RE, with an average age of 22. The verification of the suitability of the allometric scaling in the bench press, leg press and biceps curl was performed based on regression diagnostics criteria, related to the residual analysis (dispersion and homoscedasticity) and to the ability of the allometric model to provide a size-independent mass exponent. The allometric adjustments made in the present study generated exponents that were lower for men than for women and, in general, higher than the ones encountered in the literature. It was observed that the specific exponents, the theoretical (0,67) and the standard index (strength/MC1) provided non correspondent rankings, discriminating the individuals in a different manner considering 1RM strength. Furthermore, men were stronger than women in all the resistance exercises, even when the strength was adjusted through the use of allometry, in this case, however, in a reduced magnitude. All the adjustments complied in a satisfactory manner to the pre-established criteria, being that the problems in residual distribution pointed out in the allometric modeling of the performance of the weightlifting athletes were not observed in the present study. This indicates that the allometry may be an adequate tool to isolate the effect of the BM in the adjustment of the strength of non-athletes, at least for the analyzed sample, especially when compared to the adjustment provided by the standard index. / Em geral, acredita-se que o tamanho corporal representa um fator que afeta o desempenho em testes físicos e também em atividades do cotidiano, de maneira, pessoas mais altas e mais pesadas geralmente são mais fortes que as mais baixas e mais leves. A relação entre massa corporal (MC) e força muscular parece obedecer à lei de escala ou potência (Y=Y0*MCb), onde a modelagem alométrica pode servir como ferramenta prática e útil para uma adequada comparação de indivíduos de diferentes massas corporais. O objetivo do presente trabalho foi verificar a adequação do ajuste alométrico na comparação do desempenho de praticantes de exercícios resistidos (ER). A mostra foi composta por 11 homens e 11 mulheres, praticantes de ER, não atletas, com média de idade de 22 anos. A verificação da adequação dos ajustes alométricos nos exercício supino reto, leg press e rosca direta foi realizada a partir de critérios de diagnóstico de regressões, com base na análise de resíduos (dispersão e homoscedasticidade) e na habilidade do modelo em isolar o efeito da MC. Os ajustes alométricos realizados no presente estudo geraram expoentes que foram menores para homens do que para mulheres e, em geral, maiores do que aqueles encontrados na literatura. Foi observado que os expoentes específicos, o teórico (0,67) e taxa padrão (força/MC1) proporcionaram ranqueamentos não correspondentes, discriminando de maneira diferente os indivíduos em relação à força de 1RM. Além disso, os homens se apresentaram mais fortes que as mulheres em todos os exercícios resistidos, mesmo quando a força era corrigida alometricamente, porém nesse caso em menor magnitude. Além disso, todos os ajustes atenderam satisfatoriamente aos critérios pré-estabelecidos, sendo que os problemas de distribuição residual apontados em modelagem alométrica do desempenho de atletas de levantamento de peso não foram observados no presente estudo. Isso indica que a alometria pode ser uma ferramenta adequada para isolar o efeito da MC no ajuste da força muscular de não atletas, ao menos para a amostra em questão, principalmente quando comparada com o ajuste fornecido pela taxa padrão.

Made available in DSpace on 2016-12-12T17:32:56Z (GMT). No. of bitstreams: 1 RESUMO Thiele Libardoni.pdf: 84919 bytes, checksum: d4f78792f75af6800676090f1bf2750b (MD5) Previous issue date: 2014-08-25 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Muscle strengh and balance are important factors for a good motor development. Its needed reference values to evaluate and compare them. The aim of this study was to establish reference values and prediction equations for muscle strength and balance in children. Participated at this study 165 individuals, allocated into two groups, 83 male, 82 females, aged 8-12.To asses the muscle strength of flexors and extensors of knee, it s been used the isokinetic dynamometer Biodex Multi Joint System 4. Speed of 60/s was used in the concentric / concentric mode. It was used the Smart Equitest Neurocom to assess the score balance by the Sensory Organization Test (SOT).To generate normative values it was used descriptive statistics for the peak torque balance and scores, presented by the mean and standard deviation. Multiple linear regression was performed using the enter method, the independent variables: age, weight, height and average thigh circumference were allocated in blocks. The SPSS software was used for data processing and the level of significance was p &#8804; 0,05. The results showed that age is the best predictor for the score of balance and muscle strength. The other predictors (weight, height and average thigh circumference) increased slightly the ability to predict peak torque balance and scores. It was observed that with increasing age values and the peak torque balance score increases linearly with age. Reference equations were developed for each condition of the SOT and the flexors and knee extensors. The elaboration of normative data and reference equations, are going to assist the selection and development of treatments for people with impaired muscle strength and balance. / A força muscular e o equilíbrio são fatores importantes para o bom desenvolvimento motor. Ambos, para serem avaliados e comparados necessitam de valores de referência. O objetivo do estudo foi estabelecer valores de referência e equações de predição de força muscular e equilíbrio para crianças. Participaram do estudo 165 sujeitos, separados em 2 grupos, sendo 83 do sexo masculino e 82 do sexo feminino com idades entre 8 a 12 anos. A avaliação da força muscular (pico de torque) de flexores e extensores do joelho foi realizada por meio do dinamômetro isocinético Biodex Multi Joint System 4,. Foi utilizada velocidade de 60º/s, no modo concêntrico/concêntrico. A avaliação do escore de equilíbrio foi através do SmartEquitest da Neurocom por meio do Sensory Organization Test(SOT). Para gerar os valores normativos foi utilizada estatística descritiva, para o pico de torque e escore de equilíbrio, apresentada em média e desvio padrão. A regressão linear múltipla foi realizada por meio do método enter, onde as variáveis independentes: idade, peso, altura e circunferência média da coxa foram alocadas em blocos. O programa SPSS foi utilizado para o processamento dos dados e o nível de significância adotado foi de p&#8804; 0.05. Os resultados mostraram que a idade é o melhor preditor para o escore de equilíbrio e para a força muscular. Os demais preditores (peso, altura e circunferência media da coxa) aumentaram pouco a capacidade de predizer o pico de torque e escore de equilíbrio. Foi observado que com o aumento da idade os valores do pico de torque e escore de equilíbrio aumentam linearmente com a idade. Equações de referência foram desenvolvidas para cada condição do SOT e para os flexores e extensores do joelho. A elaboração dos dados normativos e equações de referência, irão auxiliar na escolha e evolução dos tratamentos em populações com alterações da força muscular e do equilíbrio

Made available in DSpace on 2016-12-12T17:32:57Z (GMT). No. of bitstreams: 1 RESUMO MAIARA.pdf: 71031 bytes, checksum: d33cc74d3a1e25403b264ce99d10abf4 (MD5) Previous issue date: 2015-07-31 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Evidence shows that functional changes in postoperative breast cancer limit some daily activities, however still not entirely clear from how long after surgery occur restrictions in grip strength and postural control in these patients. Objective: To evaluate the grip strength and postural control in the pre and postsurgical treatment in patients with breast cancer. Methods: The sample included 10 patients with breast cancer diagnosis underwent surgery as treatment. Patients were evaluated at three time points: preoperative, 30 and 60 days postoperatively. Balance was assessed by mCTSIB test (System VSRTM SPORT of NeuroCom) and grip strength by dynamometer (Jamar®). Data collection occurred in the Physiotherapy Clinic of the Maternity Carmela Dutra, in Florianópolis, Santa Catarina. To compare the values of grip strength and the center of gravity sway velocity (COG) between the three periods were used ANOVA for repeated measures with Bonferroni correction, the level of significance was set at p &#8804;0,05. For the COG alignment data descriptive analysis was used. Results: There was a significant main effect of time on the speed of oscillation in the condition of closed eyes (OF) on an unstable surface (SI) (F1-9 = 3.855; p = 0.04). The Bonferroni post-hoc test showed that the rate was significantly higher in the pre (1.58 ± 0.57 deg / s) when compared to the period 30 days after surgery (1.29 ± 0.36 deg / s). Comparing the mCSTIB test values in eyes closed condition and unstable surface between pre and 30 days after surgery the effect size showed significant clinical relevance (0.527) and 80.4% power to detect statistically real difference. The alignment of the COG was altered toward to the side ipsilateral to surgery, with reduced its limit of stability in 60 days. There were no statistical differences in the speed of oscillation in the other conditions tested, as well as the handgrip values between the pre- and postoperative period. Conclusion: After 30 days of surgery is a decrease in the balance in situations that require unstable surface and 60 days a decrease of balance maintenance strategies. Changes in grip strength even evident clinical look, showed no statistical difference. / Evidências demonstram que as alterações funcionais no pós-operatório do câncer de mama limitam algumas atividades do cotidiano, entretanto ainda não está totalmente esclarecido a partir de quanto tempo após a cirurgia ocorrem às restrições na força de preensão e no controle postural nestes pacientes. Objetivo: Avaliar a força de preensão e o controle postural no pré e póstratamento cirúrgico em pacientes com câncer de mama. Método: Amostra foi composta por 10 pacientes com diagnóstico de câncer de mama submetidos a procedimento cirúrgico como tratamento. As pacientes foram avaliadas em três momentos: pré-operatório, 30 e 60 dias de pós-operatório. O equilíbrio foi avaliado pelo teste mCTSIB (Sistema VSRTM SPORT da NeuroCom) e a força de preensão pelo dinamômetro (Jamar®). A coleta de dados ocorreu no Ambulatório de Fisioterapia da Maternidade Carmela Dutra, em Florianópolis, Santa Catarina. Para comparar os valores da força de preensão e a velocidade de oscilação do centro de gravidade (COG) entre os três períodos foram utilizados Anova de medidas repetidas com correção de Bonferroni, o nível de significância adotado foi de p &#8804;0,05. Para os dados de alinhamento do COG foi utilizada análise descritiva. Resultados: Houve efeito principal significativo do tempo na velocidade de oscilação na condição de olhos fechados (OF) em superfície instável (SI) (F1-9 = 3,855; p = 0,04). O post-hoc teste de Bonferroni mostrou que a velocidade foi significativamente maior no período pré (1,58±0,57 graus/s) quando comparada ao período 30 dias após a cirurgia (1,29±0,36 graus/s). Na comparação dos valores do teste mCSTIB na condição olhos fechados e superfície instável entre pré e 30 dias de pós-operatório o tamanho de efeito mostrou importante relevância clínica (0,527) e poder de 80,4% para detectar diferença estatisticamente real. O alinhamento do COG sofreu alteração na sua direção para o lado homolateral à cirurgia, com redução no seu limite de estabilidade em 60 dias. Não foram encontradas diferenças estatísticas na velocidade de oscilação nas demais condições testadas, bem como nos valores de preensão palmar entre os períodos pré e pós-operatório. Conclusão: Após 30 dias do procedimento cirúrgico ocorre uma diminuição no equilíbrio em situações que exijam superfície instável e com 60 dias uma diminuição das estratégias de manutenção do equilíbrio. As alterações na força de preensão palmar mesmo evidente ao olhar clínico, não apresentaram diferença estatística.

Orientadores: José Wilson Magalhães Bassani, Rosana Almada Bassani / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Engenharia Elétrica e de Computação / Made available in DSpace on 2018-08-17T02:35:28Z (GMT). No. of bitstreams: 1 Ricardo_RafaeldeAlmeida_D.pdf: 1783057 bytes, checksum: 51a4ed51fbdbcd3a024bf9f16c44793c (MD5) Previous issue date: 2010 / Resumo: A relação força-freqüência é uma característica intrínseca do músculo cardíaco, e se manifesta de diferentes formas, dependendo da espécie, e seus mecanismos ainda não estão totalmente esclarecidos. Um possível mecanismo é a modificação da liberação de Ca2+ pelo retículo sarcoplasmático (RS), principal fonte do íon para ativar a contração em miocárdio de mamíferos. O principal objetivo deste trabalho foi determinar a relação entre a liberação fracional de Ca2+ do RS (FR) e a freqüência estimulatória em miócito ventricular isolado de rato. O potencial de ação (PA) representativo medido em cada freqüência de interesse foi registrado com a técnica perforated patch clamp em temperatura ambiente (23°C). A corrente de Ca2+ tipo L (ICaL) e o transiente de Ca2+ (D[Ca2+]i, medido com indo-1) foram registrados simultaneamente por meio da técnica action potential clamp. A FR em cada freqüência foi considerada como a relação entre a diferença entre variação total de [Ca2+] e a integral de ICaL, e a carga de Ca2+ do RS ([Ca2+]RS). A duração do PA a 90% de repolarização (APD90) aumentou de 76 ± 9 ms em 0,2 Hz para 130 ± 11 ms em 2 Hz (p<0,05). Em 0,2 Hz, o pico de ICaL foi -4,5 ± 0,7 pA/PF e, com o aumento da freqüência para 2 Hz, foi reduzido para -2,7 ± 0,4 pA/pF (p<0,05). A D[Ca2+]i caiu de 603 ± 56 para 408 ± 32 nM (p<0,05), em 0,2 e 2 Hz, respectivamente. A FR também diminuiu com o aumento da freqüência, de 0,81 ± 0,02 em 0,2 Hz para 0,54 ± 0,02 em 2 Hz (p<0,01), enquanto a [Ca2+]RS permaneceu constante para todas as freqüências utilizadas. O aumento da freqüência estimulatória reduziu a D[Ca2+]i possivelmente devido à redução da FR. É possível que a redução do pico de ICaL, que é o principal trigger de liberação de Ca2+ do retículo sarcoplasmático, seja a principal causa da redução da FR. / Abstract: The force-frequency relationship is an intrinsic characteristic of cardiac muscle. It is manifested in different ways depending on the species, and its mechanisms still remain to be completely understood. A possible mechanism is the variation of Ca2+ release by the sarcoplasmic reticulum (SR), the main source of the ion for contraction activation in mammalian myocardium. The main goal of this work was to determine the relationship between the fractional SR Ca2+ release (FR) and stimulatory frequency in isolated rat ventricular myocytes. Action potentials (AP) were recorded at 23ºC using the perforated whole-cell patch-clamp technique at different rates, and the representative AP at each rate was used later as stimulus waveforms (action potential clamp). L-type Ca2+ current (ICaL) and intracellular Ca2+ transient (D[Ca2+]i, measured with indo-1) were recorded simultaneously using action potential clamp. FR at a twitch was assumed to be the ratio of the systolic variation in total [Ca2+] minus ICaL integral, and the SR content ([Ca2+]SR). AP duration at 90% repolarization (APD90) increased from 76 ± 9 ms at 0.2 Hz to 130 ± 11 ms at 2 Hz (p<0.05). At 0.2 Hz, ICaL peak was -4.5 ± 0.7 pA/pF, and it decreased to -2.7 ± 0.4 pA/pF with increasing frequency to 2 Hz (p<0.05). D[Ca2+]i decreased from 603 ± 56 nM to 408 ± 32 nM (p<0,05), at 0.2 and 2 Hz, respectively. FR also decreased with frequency, from 0.81 ±0.02 at 0.2 Hz to 0.54 ±0.02 at 2 Hz (p<0.01), whereas [Ca2+]SR did not change significantly. The negative relationship between Ca2+ transient amplitude and stimulation rate is likely to be due to the observed decrease in SR Ca2+ release. Lower FR at higher rates might be due to decrease in ICaL peak, which is the main trigger of SR Ca2+ release. / Doutorado / Engenharia Biomedica / Doutor em Engenharia Elétrica

Orientador: André Fattori / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-18T02:10:48Z (GMT). No. of bitstreams: 1 Moraes_ZeliaVieirade_M.pdf: 2183425 bytes, checksum: 4404a3b0fb6ea373f7f9f5b2941e39b3 (MD5) Previous issue date: 2011 / Resumo: Objetivos: Investigar relações entre indicadores de fragilidade, anemia e parâmetros hematimétricos (HGB, HTC, VCM, RDW, RETabs) em idosos de 65 anos e mais, recrutados na comunidade, segmentados por gênero e idade. Métodos: Os idosos foram recrutados em domicilio, em 35 setores censitários urbanos de Campinas selecionados por critério de conveniência dentre os 88 que integraram a amostra casualizada de um estudo populacional sobre fragilidade Em sessão única realizada em local publico, realizada coleta de sangue (hemograma e reticulocitos) e levantados dados sócio-demográficos, antropométricos, de saúde entre eles medidas de fragilidade, de acordo com os critérios definidos por Fried e col.(2001). Resultados: Participaram 255 idosos (68% mulheres), idade media = 73,12 anos (±5,98), escolaridade media = 4,39 anos ±4,21 anos; 25% analfabetos), e renda familiar media = 2,23 salários mínimos mensais ±2,74. A prevalência de fragilidade foi de 7,06% e de anemia, 9,8%. As mulheres frágeis apresentaram valores menores de HGB (p: 0,017/12,46 ±1,09) e maiores de RDW (p: 0,24/14,24 ± 1,43); menores valores de HGB associaram-se significativamente com baixa forca preensão e lentidão da marcha. Na amostra total, anemia (HGB <12g/dL para mulheres e < 13 g/dL para homens) associou-se com fragilidade e com perda de peso não intencional; RETabs e HGB associaram-se com idade; os valores de HGB e RETabs correlacionaram-se positiva e significativamente. Conclusões: Embora tenham sido atingidos valores no limite inferior da normalidade, em nenhum deles a média de HGB foi inferior a 12g/dL. As alterações hematimétricas estiveram mais correlacionadas com fragilidade entre as mulheres que entre os homens. Os dados sugerem a oportunidade de se buscar ativamente critérios diagnósticos mais exigentes para anemia e de empreender o rastreio sistemático dessa condição e de seus precursores na população idosa / Abstract: Objectives: To investigate relationships between indicators of fragility, anemia, and hematological parameters (HGB, HTC, MCV, RDW, RetAbs) in the elderly age 65 and over, recruited from the community, segmented by gender and age. Methods: Subjects were recruited at home, in 35 urban census tracts of Campinas selected by criteria of convenience among the 88 that made up the random sample of a population study on frailty in a single session held in a public place, was collected blood sample (blood count and reticulocytes) and collected sociodemographic, anthropometric, health, including measures of fragility, according to the criteria defined by Fried et al. (2001). Results: Participants were 255 elderly (68% women), mean age = 73.12 years ( ± .5,98), educational mean = 4.39 years ± 4.21 years, 25% illiterate), and median family income = 2 , 23 ± 2.74 times the minimum wage. The prevalence of frailty was 7.06% and anemia, 9.8%. Women showed lower values of fragile HGB (p: 0.017 / 12.46 ± 1.09) and higher RDW (p: 0.24 / 14.24 ± 1.43), lower values of HGB were significantly associated with low grip strength and slowness of gait. In the total sample, anemia (HGB <12 g / dL for women and <13 g / dL for men) was associated with frailty and with weight loss; RetAbs and HGB were associated with age, the values of HGB and RetAbs correlated positively and significantly. Conclusions: Although values have been reached at the lower limit of normal, none of them the average of HGB was less than 12 g / dL. Hematological alterations most closely correlated with weakness among women than among men. The data suggest the opportunity to actively seek more stringent diagnostic criteria for anemia and to undertake systematic screening of this condition and its precursors in the elderly / Mestrado / Mestre em Gerontologia