Submitted by Caroline Xavier (caroline.xavier@pucrs.br) on 2017-05-19T17:37:33Z No. of bitstreams: 1 TES_MELISSA_CLAUDIA_BISI_PARCIAL.pdf: 474029 bytes, checksum: cd9002527f3261fb305955c53e4f5cc3 (MD5) / Made available in DSpace on 2017-05-19T17:37:33Z (GMT). No. of bitstreams: 1 TES_MELISSA_CLAUDIA_BISI_PARCIAL.pdf: 474029 bytes, checksum: cd9002527f3261fb305955c53e4f5cc3 (MD5) Previous issue date: 2016-12-09 / Introduction: Ultrasonography (US) is an useful tool for evaluation of synovial vascularization and proliferation in rheumatoid arthritis (RA). Differently from US power Doppler (PD), the resistive index (RI) of spectral Doppler (SD) provides a quantitative analysis of vascular inflammation, but its utility in the ultrasonographic evaluation of RA activity has not been established. Objetives: To associate the RI with US parameters of synovitis and disease activity in patients with established RA. Methods: Consecutive pD-positive RA patients were included in a prospective cross-sectional study. Disease activity and disability were evaluated using the Disease Activity Score in 28-joints (DAS28) and Health Assessment Questionnaire (HAQ), respectively. Gray scale (GS) synovitis, PD and SD analysis were performed by one of two examiners in wrists, second and third metacarpophalangeal, and proximal interphalangeal joints. The 10 joint-GS and -PD scores and the mean RI were then calculated. Weighted kappa values were employed to assess interobserver reliability. Results: out of 112 patients scanned initially, 95 patients with PD signal were included (median duration of disease, 7 years and mean DAS28, 4.32 ? 1.66). Weighted kappa values in real-time US were 0.77 for synovitis, 0.87 for PD and 0.68 for RI. There was a significant association of 10 joint-GS and -PD with swollen joints count (rs = 0.54, p <0.001 and rs = 0.39, P <0.001, respectively). There were no significant correlations of the RI with 10-joint- GS, 10-joint-PD, DAS28, joint counts or HAQ (P>0.10 for all tests). Conclusion: Spectral Doppler RI did not correlate to any US or clinical parameters of disease activity in our sample of established RA patients. The addition of the RI score does not seem to improve US performance in this scenario. / Introdu??o: A ultrassonografia (US) ? uma ferramenta ?til para a avalia??o da vasculariza??o sinovial e prolifera??o na artrite reumatoide (AR). Diferentemente do sinal de power Doppler (PD), o ?ndice de resist?ncia (RI) do Doppler espectral(SD) fornece uma an?lise quantitativa de inflama??o vascular, mas a sua utilidade na avalia??o ultrassonogr?fica da atividade reumatoide n?o foi estabelecida. Objetivos: Associar o RI com par?metros ultrassonogr?ficos e ?ndices de atividade da doen?a em pacientes com AR estabelecida. M?todos: pacientes com AR PDpositivos, consecutivos, foram inclu?dos neste estudo transversal. A atividade da doen?a e a capacidade funcional foram avaliados usando o Disease Activity Score em 28 articula??es (DAS28) e Health Assessment Questionnaire (HAQ), respectivamente. Sinovite em escala de cinza (GS), PD e an?lise do SD foram realizadas por dois examinadores em punhos, segunda e terceira metacarpofalangeanas e articula??es interfalangianas proximais. Os escores 10 GS, escore10 PD e media do RI foram calculados. Os valores de kappa ponderado foram empregados para avaliar a correla??o interobservador. Resultados: dos 112 pacientes recrutados inicialmente, 95 pacientes com sinal PD foram inclu?dos (dura??o m?dia da doen?a: 7 anos; DAS28 m?dio: 4,32 ? 1,66). Os valores de kappa em tempo real US foram 0,77 para sinovite, 0,87 para PD e de 0,68 para RI. Houve associa??o significativa dos escores 10 PD e 10 GS com a contagem de articula??es edemaciadas (rS=0.54, P<0.001 e rS=0.39, P<0.001, respectivamente). N?o foram obtidas correla??es significativas entre RI e escore 10 GS, escore 10 PD, DAS28 ou HAQ (P> 0,10 para todos os testes). Conclus?o: o RI n?o se correlacionou com dados ultrassonogr?ficos ou par?metros cl?nicos de atividade da doen?a em nossos pacientes com AR estabelecida. A adi??o do RI n?o pareceu melhorar o desempenho da US neste cen?rio.

Submitted by Setor de Tratamento da Informa??o - BC/PUCRS (tede2@pucrs.br) on 2016-04-18T11:31:39Z No. of bitstreams: 1 TES_DANIELA_VIROTE_KASSICK_MULLER_COMPLETO.pdf: 2995565 bytes, checksum: 5c9ca087f0739a0b8a2c517a21a0b2ec (MD5) / Made available in DSpace on 2016-04-18T11:31:39Z (GMT). No. of bitstreams: 1 TES_DANIELA_VIROTE_KASSICK_MULLER_COMPLETO.pdf: 2995565 bytes, checksum: 5c9ca087f0739a0b8a2c517a21a0b2ec (MD5) Previous issue date: 2016-01-15 / Aging is a natural process and result of the passage of time, common to all living beings. Can be considered biologically as involution morphofunctional that affect all major physiological systems; however, in varying degrees, as it does not prevent the person ages remain active, independent and happy. Population aging is a global phenomenon and brings with it a greater concern of gerontologists for this process to occur with minimal dysfunctions and pathologies, thus preserving the old, so that it has a better chance of going through this period of life with greater functionality and autonomy as possible. Therefore, in this thesis, we present three original articles that deal with the aging process and its consequences, both functional and morphological point of view, from an evaluation of a total of 105 residents community-dwelling elderly of the west side of Rio Grande do Sul. In the first article, entitled isokinetic muscle strength of knee flexors and extensors between sarcopenic elderly and non sarcopenic, data of muscle function obtained by exclusively isokinetic dynamometer among elderly men introduced himself, classifying them according the muscular mass index (MMI) between sarcopenic and not sarcopenic. This manuscript intended to verify the actual reduction of the decrease in muscle mass associated with muscular performance and the results demonstrated decreased that older adults with decreased MMI showed reduced muscle function when compared to older people without this disorder. In the second, Comparison of muscle mass, isokinetic muscle strength test and sits and raises 30' in the elderly, the findings related to muscle function of the lower limbs in the elderly are demonstrated by comparing female and male, with and without a diagnosis of sarcopenia. This article also sought to analyze whether there was relationship between muscle function assessed by isokinetic dynamometer to test and sit up for 30 seconds between older men and women. The results made it possible to verify that, although the elderly men have a worse body mass index they have managed to preserve a better muscle function that older women compared through the isokinetic dynamometer. The third article, entitled Analysis of body balance in elderly classified into different age groups using computerized dynamic posturography (CDP), presented the data obtained from the evaluation of the body balance in the balance of cash by sensory organization test and motor control. In order to classify the elderly, this study grouped them into three age groups hoping to see if advancing age had significant association with reduced body control. Through statistical analysis it was seen that those still younger preserve a better body stability. / O envelhecimento ? um processo natural e consequ?ncia da passagem dos anos, comum a todos os seres vivos. Pode ser considerado biologicamente como a involu??o morfofuncional que afeta todos os sistemas fisiol?gicos principais; por?m, de forma vari?vel, j? que n?o impede que a pessoa que envelhece se mantenha ativa, independente e feliz. O envelhecimento populacional ? um fen?meno mundial e traz consigo uma maior preocupa??o de geront?logos para que esse processo ocorra com o m?nimo de disfun??es e patologias, preservando, assim, o idoso, a fim de que o mesmo tenha maiores chances de atravessar este per?odo da vida com a maior funcionalidade e autonomia poss?vel. Diante disso, na presente tese, s?o apresentados tr?s artigos originais que versam sobre o processo de envelhecimento e suas consequ?ncias, tanto do ponto de vista morfol?gico, quanto funcional a partir de uma avalia??o de um total de 105 idosos comunit?rios residentes da fronteira oeste do Rio Grande do Sul. No primeiro artigo, intitulado For?a muscular isocin?tica de flexores e extensores de joelho entre idosos sarcop?nicos e n?o sarcop?nicos, apresentou-se os dados da fun??o muscular obtidos atrav?s da dinamometria isocin?tica exclusivamente entre os idosos do sexo masculino, classificando-os segundo o ?ndice de massa muscular (IMM) entre sarcop?nicos e n?o sarcop?nicos. Este manuscrito pretendia verificar a real redu??o da performance muscular associada a diminui??o da massa muscular e os resultados demontraram que idosos com diminui??o do IMM apresentaram fun??o muscular reduzida quando comparados aos idosos sem esta desordem. No segundo, Compara??o da massa muscular, for?a muscular isocin?tica e teste senta e levanta 30? em idosos, s?o demonstrados os achados referentes ? fun??o muscular dos membros inferiores entre idosos, comparando sexo feminino e masculino, com e sem diagn?stico de sarcopenia. Este artigo tamb?m pretendeu analisar se haveria rela??o entre a fun??o muscular avaliada pela dinamometria isocin?tica com o teste de senta e levanta por 30 segundos entre homens e mulheres idosos. Os resultados encontrados possibilitaram verificar que, apesar de os idosos do sexo masculino apresentarem pior ?ndice de massa muscular estes conseguiram preservar uma melhor fun??o do m?sculo que as mulheres idosas quando comparados atrav?s da dinamometria isocin?tica. O terceiro artigo, com o t?tulo de An?lise do equil?brio corporal em idosos classificados em diferentes faixas et?rias atrav?s da posturografia din?mica computadorizada (PDC), apresentou os dados obtidos atrav?s da avalia??o do equil?brio corporal na caixa de equil?brio pelos testes de organiza??o sensorial e controle motor. A fim de classificar os idosos, este estudo os agrupou em tr?s faixas et?rias na expectativa de visualizar se o avan?o da idade apresentava rela??o significativa com a redu??o do controle corporal. Atrav?s da an?lise estat?stica foi visto que os idosos considerados mais jovens preservam uma melhor estabilidade corporal.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2016-06-23T21:52:18Z No. of bitstreams: 1 EmmanoelClaudioFagundesLeite_DISSERT.pdf: 1080199 bytes, checksum: 3787992cde887a2962158004452a0925 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2016-06-28T21:48:59Z (GMT) No. of bitstreams: 1 EmmanoelClaudioFagundesLeite_DISSERT.pdf: 1080199 bytes, checksum: 3787992cde887a2962158004452a0925 (MD5) / Made available in DSpace on 2016-06-28T21:48:59Z (GMT). No. of bitstreams: 1 EmmanoelClaudioFagundesLeite_DISSERT.pdf: 1080199 bytes, checksum: 3787992cde887a2962158004452a0925 (MD5) Previous issue date: 2015-05-19 / Objetivo: Avaliar os efeitos do Kinesio Taping (KT) sobre os marcadores cl?nicos indiretos do dano muscular induzido pelo exerc?cio exc?ntrico nos flexores do cotovelo, em indiv?duos saud?veis. Materiais e m?todos: Trata-se de um ensaio cl?nico e randomizadocom 60 volunt?rias entre 18 a 28 anos, recrutadas por conveni?ncia e distribu?das em tr?s grupos com 20 integrantes:Grupo controle (GC) - submetidas ao protocolo exc?ntrico sem KT, Grupo KT (KT) - protocolo exc?ntrico com KT tensionado e Grupo Placebo (GP) - protocolo exc?ntrico com KT sem tens?o. As volunt?rias foram avaliadas em quatro momentos: o primeiro foi linha de base (AV1), o segundo imediatamente ap?s o protocolo de exerc?cio (AV2) e os dois seguintes 24h (AV3) e 48h (AV4) ap?s a interven??o. O dano muscular foi induzido por meio de contra??es exc?ntricas m?ximas dos flexores do cotovelo do membro n?o dominante a 60?/s.Foram analisados: a amplitude articular em repouso, o n?vel de dor, o senso de posi??o articular (SPA), o desempenho isocin?tico e a atividade eletromiogr?fica. Os dados foram analisados no software SPSS 20.0. A normalidade foi verificada pelo teste de Kolmogorov-Smirnov e utilizada ANOVA de modelo misto, com signific?ncia de 5%, para verificar eventuais diferen?as entre os grupos. Resultados: Observou-se diminui??o da amplitude articular e aumento imediato da dor que elevou com 24 horas e permaneceu at? 48 horas em todos os grupos, mas sem diferen?as entre os grupos.N?o houve diferen?a no SPA. As vari?veis pico de torque normalizado, pico de torque m?dio, trabalho total e pot?ncia m?dia reduziram at? 48 horas ap?s dano muscular, em todos os grupos. N?o houve diferen?a nos valores eletromiogr?ficos entre os grupos. Conclus?o: O KT n?o influencia nos marcadores cl?nicos indiretos de dano muscular induzido pelo exerc?cio exc?ntrico nos flexores de cotovelo, em indiv?duos saud?veis. / Objective: analyze the effect of Kinesio Taping (KT) on the indirect clinical markers of muscle damage induced by eccentric exercises in the elbow flexors in healthy individuals. Materials and methods: It is a randomized controlled trial involving sixty volunteers at age group between 18 and 28 years randomly selected. The sample into three groups with twenty participants: control group (CG) ? eccentric protocol without KT, KT group ? eccentric with tensioned KT, placebo group ? eccentric protocol KT with no tension. The evaluations took place at four moments; the first one was the basis line (AV1), after the second protocol (AV2) and the following two groups 24 (AV3) and 48 hours (AV4) after the intervention protocol. The muscle damage was induced by sixteen maximum eccentric contractions of the elbow flexors from the non-dominant limb, divided in two sets of eight repetitions, at 60?/s, with two minutes interval. The variables analyzed were: the joint amplitude in rest, the level of pain, the joint position sense (JPS) followed of isokinetic checking with electromyographic sign capitation. These data were analyzed in software SPSS 20.0. The normality was identified by Kolmogorov-Smimov examination and then, being used the ANOVA mixed model with significance of 5%. Outcomes: a decrease was observed at joint amplitude moreover, an immediate increase of pain wich increased after 24 and remained until 48 hours at all groups searched. There was not difference at the JPS. The variables peak torque, average peak torque, total work and mean power mean reduced until 48 hours after muscle lesion in all groups. Among the groups, there was no difference in EMG values and for any of the variables. Conclusion: The KT did not influence at the indirect clinical markers of muscle lesion induced by eccentric exercises in the elbow flexors in healthy people.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2017-06-02T22:17:33Z No. of bitstreams: 1 NathalieCortezBezerraDeMedeiros_DISSERT.pdf: 1947192 bytes, checksum: 191bf33e4eb1f0d2955ff10f51d47523 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2017-06-08T20:06:08Z (GMT) No. of bitstreams: 1 NathalieCortezBezerraDeMedeiros_DISSERT.pdf: 1947192 bytes, checksum: 191bf33e4eb1f0d2955ff10f51d47523 (MD5) / Made available in DSpace on 2017-06-08T20:06:08Z (GMT). No. of bitstreams: 1 NathalieCortezBezerraDeMedeiros_DISSERT.pdf: 1947192 bytes, checksum: 191bf33e4eb1f0d2955ff10f51d47523 (MD5) Previous issue date: 2017-03-28 / Introdu??o: A falha na fun??o da bomba muscular da panturrilha ? considerada a principal causa da insufici?ncia venosa cr?nica (IVC) e a hipertens?o venosa prolongada, leva ao enfraquecimento da musculatura da panturrilha. A avalia??o espec?fica dessa musculatura pode ser feita de diferentes formas, entre elas a utiliza??o do teste de eleva??o do calcanhar (TEC). Atualmente, v?rios protocolos foram desenvolvidos para a realiza??o do TEC em diferentes popula??es, sem uma padroniza??o bem detalhada. Objetivos: Primariamente avaliar a confiabilidade e reprodutibilidade tanto intra quanto inter-avaliadores do TEC em adultos saud?veis, de dois diferentes protocolos com diferentes est?mulos: auto-cadenciado (TECAC) e externamente cadenciado (TECEC); Secundariamente, avaliar o desempenho e a atividade el?trica dos m?sculos dos membros inferiores durante a realiza??o do TECEC em sujeitos com IVC comparando com indiv?duos saud?veis pareados. M?todos: Dois estudos foram realizados e ambos foram do tipo observacional, de car?ter transversal. Para o Estudo 1, dois protocolos do TECAC e TECEC foram realizados em sujeitos jovens e saud?veis. Para o Estudo 2, foram recrutados sujeitos com idade entre 35 e 65 anos, com diagn?stico cl?nico de IVC para realiza??o do TECEC associado ? Eletromiografia de Superf?cie (EMGs). Resultados: No estudo 1, 33 indiv?duos saud?veis foram recrutados (16H), com idade de 23,03 anos (?2,71). Observamos que o TECAC obteve um melhor resultado tanto no que diz respeito ao desempenho (53,01 eleva??es) quanto ? reprodutibilidade relativa inter-avaliador (CCI=0,77) e, o TECEC obteve melhor reprodutibilidade intra-avaliador (CCI=0,69). Foi observado que ao final da realiza??o de ambos os testes houve aumento dos sintomas de fadiga (p<0,01); entretanto, com manuten??o do desempenho de eleva??es de calcanhar nos tr?s TECAC (p=0,76) e diminui??o do desempenho no TECEC quando comparados T1, T2 e T3 (p<0,01). No Estudo 2, foram recrutados 44 sujeitos com IVC, dos quais 17 atingiram todos os crit?rios de inclus?o e compuseram a amostra do Grupo IVC, versus 17 sujeitos saud?veis pareados por idade, sexo e IMC que compuseram o Grupo Controle. Houve diferen?a significante na compara??o intergrupo do desempenho do TECEC (p<0,01) e tamb?m na compara??o intergrupo do tempo gasto para realiza??o do TECEC (p<0,05). A plantiflex?o no membro inferior direito foi significativamente menor (p<0,05) no Grupo IVC. Para avalia??o da atividade el?trica, o TECEC foi dividido em quatro momentos (25%, 50%, 75% e 100%). Na avalia??o da atividade el?trica muscular durante o TECEC, foram encontradas diferen?as significantes nos momentos 50% e 75% (p<0,05) do m?sculo tibial anterior direito e nos momentos 25% e 50% (p<0,05) do m?sculo tibial anterior esquerdo. Conclus?o: Nossos resultados do Estudo 1 demonstram que ambos os TEC (auto-cadenciado e externamente cadenciado) podem ser utilizados para fornecer resultados de desempenho muscular. O TECEC potencialmente determina uma maior e mais intensa atividade muscular e o TECAC demonstrou melhor reprodutibilidade e maior concord?ncia, quando avaliado o desempenho nos tr?s momentos. Em rela??o ao Estudo 2, ? poss?vel observar que os indiv?duos com IVC apresentam um desempenho inferior no TECEC comparados a sujeitos saud?veis, com menor atividade el?trica muscular em tibial anterior bilateralmente j? em est?gios iniciais da doen?a. / Background: Failure of calf muscle pump function is considered a major cause of venous insufficiency (CVI) and prolonged venous hypertension leads to weakening of the calf muscles. The evaluation can be done from different forms, from a heel lift test (TEC). Currently, several protocols have been developed for an ECT test in different populations, without a very detailed standardization. Objectives: Firstly to evaluate the reliability and reproducibility of intra-r inter-raters in healthy adults, from two different protocols with different stimuli: self-paced (TECAC) and externally cadenced (TECEC); secondarily, to evaluate the performance and electrical activity of lower limb muscles during an TECEC in subjects with CVI compared with healthy paired subjects. Methods: Two studies were performed and both were of the observational type, with a transversal character. For Study 1, two TECAC and TECEC protocols were performed on healthy young subjects. For Study 2, subjects with ages between 35 and 65 years old were recruited, with a clinical diagnosis of CVI to perform TECEC associated with Surface Electromyography (EMGs). Results: In study 1, 33 healthy subjects were recruited (16H), aged 23.03 years (? 2.71). We observed that the TECEC obtained a better result both in terms of performance (53.01 elevations) and relative inter-rater reproducibility (ICC = 0.77) and the TECEC obtained better intra-rater reproducibility (ICC = 0, 69). It was observed that at the end of both tests there was an increase in fatigue symptoms (p <0.01); (P = 0.76) and decreased performance in the TECEC when compared to T1, T2 and T3 (p <0.01). In Study 2, 44 subjects with CVI were recruited, of whom 17 met all inclusion criteria and composed the sample of Group IVC versus 17 healthy subjects matched for age, sex and BMI who composed the Control Group. There was a significant difference in the intergroup comparison of the TECEC performance (p <0.01) and also in the intergroup comparison of the time spent to perform the TECEC (p <0.05). The flexure in the right lower limb was significantly lower (p <0.05) in Group IVC. For evaluation of electrical activity, the TECEC was divided into four moments (25%, 50%, 75% and 100%). In the evaluation of the muscular electrical activity during the TECEC, significant differences were found in the moments 50% and 75% (p <0.05) of the right anterior tibial muscle and moments 25% and 50% (p <0.05) of the muscle Anterior tibialis. Conclusion: Our results from Study 1 demonstrate that both (self-paced and externally paced) ECT can be used to provide muscle performance results. The TECEC potentially determines a greater and more intense muscular activity and the TECAC demonstrated better reproducibility and greater agreement, when evaluated the performance in the three moments. Regarding Study 2, it is possible to observe that individuals with CVI present inferior performance in the TECEC compared to healthy subjects, with lower muscular electrical activity in the anterior tibial bilaterally already in the initial stages of the disease.