Submitted by Nadir Basilio (nadirsb@uninove.br) on 2018-07-17T21:39:39Z No. of bitstreams: 1 Juliana Teles Tavares.pdf: 1123645 bytes, checksum: 9e99e680358658c37b4d41e510f9513a (MD5) / Made available in DSpace on 2018-07-17T21:39:39Z (GMT). No. of bitstreams: 1 Juliana Teles Tavares.pdf: 1123645 bytes, checksum: 9e99e680358658c37b4d41e510f9513a (MD5) Previous issue date: 2016-12-16 / The practice of physical exercise has been an important alternative to minimize the effects of age on postural control, however, there is a possibility that interruption of training (detraining) may contribute to the performance of static balance return to pre- training. The objective of this study was to analyze the action of multicomponent physical exercise on the postural control of the elderly and its effects after the period of detraining. The postural control of 31 women aged 60 to 80 years was evaluated in six different conditions on a force platform in the following conditions: static position with and without visual afferent (open eye and closed eye); Static position with the use of a foam on the platform with and without visual gauge; Static position with visual and auditory stimulation with and without the use of foam on the force platform. These variables were used to analyze the effects of two types of training for the elderly, being divided into two groups: Multicomponent Group (GM): training with strength, aerobic, balance and flexibility exercises and Control Group (CG): training with Aerobic exercise and flexibility. All participants underwent a 16-week training period, three times a week (total of 48 sessions). The postural control was analyzed before and after the training period and with 6 weeks of training. In the analysis of variance (ANOVA) it was possible to verify that the training provided significant (F = 24.72, p <0.0001) in the oscillation frequency between the groups (multicomponent group vs control group). The multicomponent group showed a significant decrease in the oscillation frequency after the training period (p <0.05), but the values observed after the training period were not different from those observed in the pre-training (p> 0.05). In this study it was possible to observe that sixteen-week training with multi-component exercises improves the postural control of elderly women. However, these effects are not maintained after a six-week period of detraining. / A prática de exercícios físicos tem sido uma alternativa importante para minimizar os efeitos da idade sobre o controle postural, porém, existe a possibilidade de que a interrupção do treinamento (destreino) possa contribuir para que o desempenho do equilíbrio estático retorne aos valores de pré-treinamento. O objetivo deste estudo foi analisar a ação do exercício físico multicomponente no controle postural de idosas e seus efeitos após período de destreino. O controle postural de 31 mulheres com idade entre 60 e 80 anos foi avaliado em seis diferentes condições sobre uma plataforma de força nas seguintes condições: posição estática com e sem aferência visual (olho aberto e olho fechado); posição estática com o uso de uma espuma sobre a plataforma com e sem aferência visual; posição estática com estímulo visual e auditivo com e sem o uso de espuma sobre a plataforma de força. Estas variáveis foram utilizadas para as análises dos efeitos de dois tipos de treinamento para idosas, sendo essas divididas em dois grupos: Grupo Multicomponente (GM): treinamento com exercícios de força, aeróbio, equilíbrio e flexibilidade e Grupo Controle (GC): treinamento com exercícios aeróbios e flexibilidade. Todos os participantes foram submetidos à um período de 16 semanas de treinamento, sendo estes realizados três vezes por semana (total de 48 sessões). O controle postural foi analisado pré e pós período de treinamento e com 6 semanas de destreino. Na análise de variância (ANOVA) foi possível verificar que o treinamento proporcionou diferença significativa (F=24,72; p < 0,0001) na freqüência de oscilação, entre os grupos estudados (grupo multicomponente vs grupo controle). O grupo multicomponente apresentou diminuição significativa na frequência de oscilação após o período de treinamento (p <0,05) porém, os valores observados após o período de destreino não foram diferentes dos observados no pré-treinamento (p>0,05). Nesse estudo foi possível observar que o treinamento de dezesseis semanas com exercícios multicomponentes melhora o controle postural de mulheres idosas. No entanto, esses efeitos não são mantidos após um período de destreino de seis semanas.

Introduktion: Balans definieras som förmågan att kontrollera tyngdpunkten i förhållande till understödsytan. Bålen är centrum av de kinetiska kedjorna och har en betydelsefull roll vid utförande och kvalitén på rörelser. Tidigare studier har föreslagit att bålstabilitetsträning har en positiv effekt på dynamisk balans. Nedsatt balans kan ge upphov till skador och rehabilitering av dessa sker ofta kliniskt. Syfte: Syftet med studien var att undersöka sambandet mellan bålstabilitet och dynamisk balans hos unga friska individer. Metod: Studien omfattade 8 försökspersoner. Förfrågan om medverkan sändes till sex klassgrupper med universitetsstudenter på Facebook. Dynamisk balans testades via star excursion balance test och bålstabiliteten testades via core muscle strength and stability test. Resultat: Mellan bålstabilitet och dynamisk balans vid stående på höger fot och sträckning av vänster fot, fanns ett måttligt positivt samband vid riktning posteriomedialt (r=0.63). Samt ett lågt positivt samband vid riktning posteriolateralt (r=0.35). Ett lågt negativt samband kunde ses vid stående på vänster fot och sträckning av höger fot, i den anteriora riktningen (r=-0.45). Konklusion: Samband kan antydas mellan bålstabilitet och dynamisk balans vid enstaka sträckriktningar och skiljer sig beroende på stödfot. Större studier behövs för vidare undersökning inom området.

L’objectif de ce travail était d’améliorer la prévention de la chute des séniors en améliorant la détection des personnes à risque et les outils d’évaluation du contrôle postural ainsi qu’en utilisant un programme de réhabilitation par électrostimulation. Afin de répondre à ces trois objectifs, trois parties ont été développées :Le but de la partie I était d’apporter des outils permettant une meilleure détection des personnes à risque à travers l’identification de facteurs responsables d’un déclin du contrôle postural. Nous avons pu établir lors de trois études que (i) les personnes consommant cinq médicaments et plus par jour présentent un risque accru des troubles de la cognition et de la mobilité, (ii) les chuteurs fracturés ont un déficit de stabilisation après le passage d’obstacle et (iii) les chuteurs fracturés réduisent moins leur vitesse de marche lors de la double tâche. Dans la partie II nous avons évalué pour la première fois le freinage du centre de masse, paramètre corrélé à la qualité du contrôle postural, avec une technique d’analyse cinématique. Il a été mis en évidence que l’analyse sur plateforme de force, habituellement utilisée, présente une plus grande variabilité et conduit à une sous-estimation de l’indice de freinage, en comparaison à cette nouvelle méthode d’analyse. Dans la partie III nous avons testé l’efficacité d’un programme d’électrostimulation des muscles mobilisateurs de la cheville sur les facteurs de risque de chute. Cet entrainement a permis d’augmenter la force des muscles et bien que la réhabilitation d’autres muscles semble nécessaire afin d’améliorer la marche, le programme a réhabilité efficacement les performances d'équilibre / The objective of this work was to improve the prevention of falls in seniors by (i) improving the detection of people at risk, (ii) providing new tools for assessing postural control and (iii) studying the effects of rehabilitation program by electrostimulation on the markers of the risk of falling. In order to meet these three objectives, three parts were developed:The aim of Part I was to provide tools for better detection of persons at risk of falls or fractures through the identification of factors responsible for a decline in postural control. We have been able to establish through three studies that (i) elderly patients who take five or more drugs per day are at higher risk of cognitive and mobility impairments, (ii) subjects who undergo fractures have a stabilization deficit after obstacle crossing and (iii) fractured fallers reduce their walking speed less during dual-task walking.In Part II we evaluated for the first time the braking of the center of mass, a parameter correlated with the quality of the postural control, with a kinematic analysis technique. It has been demonstrated that the technic usually used, the force-plate analysis, presents greater variability and leads to an underestimation of the braking index in comparison with this new method of analysis.In Part III we tested the effectiveness of a training program by electrostimulation of the ankle plantar and dorsiflexors on the parameters related to the fall or its severity. This training increased the strenght, and probably the contraction speed of the ankle muscles. Although the rehabilitation of other muscles seems necessary to improve gait,the training program has rehabilitated dynamic balance.

The theoretical part of the diploma thesis describes the role of abdominal muscles in intra-abdominal pressure and the effect on postural stabilization. The issue of postural stabilization was analyzed in a physiological situation and frequent pathologies related with inadequate postural stabilization have been described. The current possibilities of evaluating the activity of abdominal muscles and intra-abdominal pressure were presented. Methodology: 25 healthy probands (mean age 22.4 years, SD ± 1.76) were evaluated in five posturally different situations - breathing stereotype test, intra-abdominal pressure regulation test, diaphragm test, hip flexion test and arm elevation test. Testing was performed with a prototype of the DNS Brace digital pressure sensor. The resulting pressure values of the abdominal wall expansion were correlated with the corresponding postural tests according to the DNS concept, which were performed by two DNS instructors with more than five years of experience. Results: A statistically significant correlation (p = 0.001 to 0.24) between abdominal wall pressure values and palpation-evaluated postural tests was demonstrated in four of the five tested positions. Correlation was strong in diaphragm test (r = 0.75 and 0.661) and mean in other tests (r = 0.567 to 0.415). Only...

Parmi toutes les informations sensorielles que le système nerveux central doit intégrer afin d'établir la commande musculaire permettant d'assurer une position debout, nous nous sommes plus particulièrement intéressés à ce qui est nommé le " toucher léger ". En effet, il a été montré que poser le doigt sur une surface fixe, même légèrement, fournissait une information supplémentaire permettant d'améliorer le contrôle postural. De manière intéressante, lorsque la surface est mise en mouvement, un couplage apparait entre ces mouvements et le balancement postural. Nous avons lors de nos travaux étudié comment cette information était intégrée au contrôle postural. En se basant sur les conclusions de cette étude, nous avons proposé une loi de commande en boucle fermée basée sur la modulation de la vitesse du doigt, qui permet de contrôler la position du centre de pression autour d'une consigne prédéfinie. Nous avons de plus étudié les conditions expérimentales pouvant affecter les performances de cette boucle fermée (instruction, conscience des mouvements du doigt, ajout/retrait d'un sens (la vision), action de rejet volontaire du couplage). Ces études nous permettent de proposer une explication exhaustive des mécanismes expliquant ce phénomène de couplage entre la posture et les mouvements du doigt. La loi de commande proposée permet de guider le centre de pression autour d'une consigne prédéfinie, tout en ne nécessitant ni la coopération ni la concentration des sujets, et présente ainsi un intérêt certain dans les domaines de l'assistance ou de la rééducation. Nous avons donc mené une étude préliminaire en milieu clinique démontrant le potentiel applicatif de cette dernière. / Among the sensory information allowing to control postural balance, we have focused our research on Light Touch. Indeed, it has been shown that lightly touching a motionless surface, provides additional sensory information that improves balance. Interestingly, when the surface is moved slowly, a coupling appears between its motion and postural sway. We have investigated the mechanisms underlying this coupling. Based on our findings, we implemented a closed-loop control law, based on the modulation of the finger velocity, which allows to control the position of the center of pressure around a pre-defined trajectory. We also studied the experimental conditions that could influence the performance of the closed loop (instruction, awareness of finger movements, adding / removing a sensory inputs (vision), voluntary dismissal of action coupling). These studies allow us to offer a comprehensive explanation of the mechanisms underlying this phenomenon of coupling between the posture and movements of the finger. The proposed control law allows to guide the center of pressure around a pre-defined trajectory, without any cooperation from the participants. It could have an interest in the areas of assistance or rehabilitation as a new biofeedback. We therefore conducted a preliminary study in a clinical environment.

Le système postural est un complexe sensori-moteur qui assure deux grandes fonctions, la stabilisation et l’orientation du corps dans l’espace. Le contrôle postural est permis par l’intégration de trois entrées sensorielles - vestibulaire, somatosensorielle et visuelle-, par le système nerveux central qui réalise les transformations appropriées et coordonnées de ces informations pour générer les réponses musculaires adaptées. Durant de nombreuses années, la posture a été considérée comme un système régulé de façon automatique, mais de récentes études ont mis en évidence l’existence d’une régulation par des processus attentionnels. Le paradigme de double-tâche a été utilisé dans de nombreuses études chez l’adulte puis plus récemment chez l’enfant afin de comprendre les interférences entre une tâche cognitive et une tâche posturale. Les interactions dépendent de différents facteurs tels que la difficulté de la tâche cognitive, la difficulté de la tâche posturale, le contexte environnemental, les capacités attentionnelles et l’âge. Le choix de la tâche oculomotrice comme tâche associée à la tâche posturale permet d’observer les réponses comportementales des adultes et des enfants dans des tâches impliquant différents niveaux attentionnels et différentes régions cérébrales. Les tâches oculomotrices sont réalisées à partir de paradigmes expérimentaux permettant de stimuler différents types de saccades. L’objectif de cette thèse est de comprendre les interactions entre le système postural et le système oculomoteur chez l’enfant en utilisant le paradigme de double-tâche. Nous avons d’abord exploré ces interactions chez le jeune adulte puis nous avons comparé les performances posturales et oculomotrices des adultes à celles des enfants âgés de 7 à 12 ans. Nous avons enregistré les mouvements oculaires et les paramètres posturaux lors de la réalisation de trois tâches oculomotrices - fixation, saccades réactives et anti-saccades- réalisées simultanément au maintien de la posture dans deux tâches posturales, - Romberg et Romberg sensibilisé-. Les enfants de 7-8 ans réalisent sur le plan oculomoteur les saccades réactives comme les adultes, leurs paramètres posturaux sont cependant plus élevés. L’augmentation de la difficulté de la tâche oculomotrice comme dans la tâche d’anti-saccades entraine une forte dégradation des paramètres oculomoteurs et posturaux des enfants de 7-12 ans. De façon générale, les résultats montrent que la difficulté de la tâche oculomotrice entraine des modifications des paramètres posturaux et que la difficulté de la tâche posturale ne semble pas modifier les paramètres oculomoteurs. Ces interférences peuvent être associées à un nombre important de structures cérébrales communes activées pour ces deux tâches. / The postural system is a sensory motor complex controlled which permit two high functions, the stabilization and the orientation of body. The postural control is permit by the integration of three sensorial inputs, vestibular, somatosensory and visuals by the central nervous system; it carries adaptative transformations and coordinates this information to generate the appropriate muscles responses. For a long time, the posture has been considered like as an automatic system, but recents studies showed the regulation by attentionals processes. Further studies used the dual-task paradigm in adults and more recently in children, to understand interferences between a cognitive task and a postural task. The interactions depend on various factors such as the difficulty of the cognitive task, the difficulty of the postural task, the environmental context, the attentional capacity and the age. Choose oculomotor task as task associated at postural task allows simple, varying the protocol used to observe the behavior of adults and children in tasks involving different attentionals levels and different brain regions. Several experimental oculomotors paradigms allow to stimulate different types of saccades. The objective of this thesis is to understand, by using the dual-task paradigm, the interactions between the oculomotor system and the postural system in children. Initially, we observed these interferences in young adults then we compared the adults postural and oculomotor performance to those of children aged 7 to 12 years. Three oculomotor tasks, fixation, reactive saccades and antisaccades, were recorded simultaneously to two postural tasks, standard Romberg and tandem Romberg. Children aged 7-8 years achieve on oculomotor performance the reactive saccade task like adults, by cons their postural parameters are higher than adults. When we increase the difficulty of the oculomotor task, in case in antisaccade task, leads very quickly at the decrease of the oculomotor and postural performances for children aged 7 to 12 years. Generally, results show that the oculomotor difficulty leads to modifications of postural parameters and the postural difficulty do not seem modify the oculomotor parameters. These interferences can be associated with a large number of common brain structures activated for both tasks.

Orientador: Fabio Augusto Barbieri / Resumo: A locomoção e o controle postural são duas tarefas muito presentes no cotidiano e que impactam diretamente no nível de funcionalidade e na qualidade de vida. Sabemos que em pessoas com DP apresentam desordens nessas tarefas e que a medicação dopaminérgica melhora os parâmetros motores na locomoção e no controle postural em pessoas com DP. Entretanto, o tempo para o início da eficácia da medicação após sua ingestão na locomoção e no controle postural em pessoas com DP, especialmente em tarefas desafiadoras, ainda é controverso, assim como a duração desta eficácia. Assim, o objetivo geral desta dissertação é analisar o comportamento da ação da medicação dopaminérgica na locomoção e no controle postural em pessoas com DP. Para isso foram desenvolvidos dois estudos, no primeiro estudo, foi avaliado o comportamento temporal da medicação dopaminérgica no andar e no segundo estudo, no controle postural. Participaram dos estudos 15 pessoas com DP (sendo 6 do gênero feminino; 69 ±7 anos; H&Y 1 - 3; UPDRS-III 27,1 ± 12), avaliadas em dois dias distintos. No primeiro dia foram realizadas avaliações clínicas dos sintomas motores e do equilíbrio estático e dinâmico No segundo dia foi avaliado o andar e o controle postural. Os participantes foram avaliados no estado “OFF” da medicação, logo após a ingestão da medicação e a cada 30 minutos, até o período de três horas após a ingestão da medicação. Para responder aos objetivos dos estudos, os dados referentes a locomoção e ao controle postur... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Gait and postural control are two tasks that are present in daily life and that directly affects the level of functionality and quality of life. We know that in people with PD have disorders in these tasks and that dopaminergic medication improves motor parameters in gait and postural control. However, the time to onset of medication efficacy after ingestion in gait and postural control in people with PD, especially in challenging tasks, is still controversial, as is the duration of this efficacy. Therefore, the general objective of this dissertation is to analyze the behavior of the action of dopaminergic medication on gait and postural control in people with PD. For this, two studies were developed, in the first study, we evaluated the temporal behavior of dopaminergic medication in gait and in the second study, in postural control. Participated in the study 15 people with PD (6 females; 69 ± 7 years; H&Y 1 - 3; UPDRS-III 27.1 ± 12), evaluated on two different days. In the first, he performed clinical evaluations of motor symptoms and static and dynamic balance. On the second day, we evaluated walking and postural control. Participants have evaluated the “OFF” state of medication, immediately after the ingestion of medication and every 30 minutes, up to three hours after the ingestion of medication. In order to meet the objectives of the studies, the data related to gait and postural control will be compared by ANOVAs with factors according to the independent variables of e... (Complete abstract click electronic access below) / Mestre

Des évidences suggèrent que l’entraînement golfique améliore l’acuité proprioceptive et la stabilité posturale. Cependant, la proprioception du membre supérieur des golfeurs experts n’a jamais été évaluée. De plus, aucune étude ne s’est intéressée à la demande attentionnelle de la performance motrice des golfeurs élites. Nous avons comparé la performance de golfeurs élites à celle de non-athlètes sédentaires dans deux tâches motrices effectuées sans vision : une tâche d’atteintes manuelles vers des cibles proprioceptives situées dans l’espace tridimensionnel et une tâche de limites de la stabilité posturale dynamique. Ces tâches étaient effectuées isolément (tâche simple) ou simultanément à une tâche cognitive attentionnelle de soustraction mathématique (tâche double). La précision et la variabilité des atteintes manuelles étaient mesurées à l’aide d’un système d’analyse de mouvement. Les limites de la stabilité posturale étaient quantifiées à partir des déplacements des centres de pression obtenus à l’aide d’une plateforme de force. Nos résultats démontrent que les atteintes manuelles des golfeurs élites sont moins variables que ceux des sujets témoins uniquement dans la condition de tâche double. La performance cognitive des golfeurs est également meilleure que celles des sujets témoins en condition de tâche double. Par ailleurs, les limites médio-latérales de la stabilité posturale des golfeurs élites sont plus grandes que les non-athlètes et mobilisent, en moyenne, moins de ressources attentionnelles. Ensemble, ces résultats suggèrent que l’entraînement golfique augmente l’efficacité de contrôle proprioceptif des mouvements de bras et de la stabilité posturale et diminue les exigences attentionnelles de la performance motrice. / Evidence suggests that golf training improves proprioceptive acuity and postural stability. However, proprioceptive sensitivity at the upper limb has never been investigated in expert golfers. Furthermore, no previous study assessed the attentional demand of motor performance in elite golfers. We compared the performance of elite golfers to sedentary non-athletes in two motor tasks performed without vision: a task involving reaching movements to proprioceptive targets located in three-dimensional space and a dynamic postural stability limit task. These tasks were performed alone (single-task) and simultaneously to a cognitive-attentional subtraction task (dual-task). The accuracy and variability of reaching movements were measured using a motion analysis system. The limits of postural stability were quantified from center of pressure displacements recorded with a force platform. Our results demonstrated that reaching movements of elite golfers were less variable than those of control subjects only in the dual task condition. As well, the cognitive performance of elite golfers was better than those of non-athletes in the dual task condition. Moreover, the medio-lateral stability limits of elite golfers were larger than those of non-athletes and, on average, mobilized less attentional resources. Together, these results suggest that golf training increases the efficiency of the proprioceptive control of arm movements and postural stability and decreases the attentional demand of motor performance.

Virtual reality (VR) is becoming increasingly important in balance training. However, the influence of VR generated visual perturbation, through the novel virtual moving room paradigm, is unknown. Thirty healthy individuals had their static balance assessed on a BTrackS balance plate under eight different conditions: baseline eyes open and eyes closed with and without VR, unexpected toward and away moving VR perturbation, and expected toward and away moving VR perturbation. Multiple statistical analyses were conducted, and the results revealed significantly higher postural sway variables in the unexpected moving toward trials compared to the other moving room conditions; significantly higher postural sway variables in the eyes open no VR compared to VR; and significantly higher postural sway variables in the eyes closed no VR compared to VR. This study provides evidence that VR can be used as a safe and low-cost balance training tool by exposing individuals to fall-prone situations and increasing their balance confidence.

While it has been established that postural control is affected by executive function, research is lacking in identifying if specific executive function components are most responsible or if certain aspects of postural control are more affected than others (e.g., proprioception, vestibular, visual). The current study examined the role of inhibition, processing speed, and visuospatial ability in postural control under conditions affecting visual, proprioceptive, and vestibular sensory input. Cognitive assessments consisted of the Flanker Inhibitory Control and Attention Test, Digit Symbol Substitution Test, Clock Drawing Test, Trail Making Test – Part B, and simple reaction time. Standing Balance was used to assess postural sway. Analyses revealed that average balance was significantly associated with simple reaction time (r(88) = -0.31, p < .01) and the clock drawing test (r(88) = -0.25, p< .05). Further analyses revealed a significantly stronger relationship between pose #1 (eyes opened, firm) and average balance (r(88) = -0.845, p< 0.1) when compared to pose #2 (eyes closed, firm), and pose #3 (eyes opened, foam) and average balance r(88) = -0.8015, p< 0.1) when compared to pose #4 (eyes closed, foam). The significantly stronger relationship between these two measures demonstrates that visual input in both conditions #1 and #3 was associated with better postural control. The findings of this study demonstrate that reaction time and visuospatial abilities are associated with overall postural control in healthy older adults. Results suggest that reaction time should be more thoroughly researched to determine the extent of its influence on EF and physical function.