Submitted by Fabiana Gonçalves Pinto (benf@ndc.uff.br) on 2015-12-03T17:58:33Z No. of bitstreams: 1 Elciana de Paiva Lima Vieira.pdf: 2734767 bytes, checksum: 2012314a94d9af7c5d04bfe60feb71ac (MD5) / Made available in DSpace on 2015-12-03T17:58:33Z (GMT). No. of bitstreams: 1 Elciana de Paiva Lima Vieira.pdf: 2734767 bytes, checksum: 2012314a94d9af7c5d04bfe60feb71ac (MD5) Previous issue date: 2014 / Mestrado Acadêmico em Ciências do Cuidado em Saúde / O processo de envelhecimento acarreta uma série de mudanças anatômicas, fisiológicas, biomecânicas, psicológicas, afetivas e sociais. Essas alterações podem levar ao comprometimento da execução das atividades cotidianas e aumentar o risco de acidentes por queda. Atualmente, a queda no idoso é um episódio preocupante devido à alta incidência e suas consequências, afetando sua qualidade de vida. Entre os diversos fatores de risco, a debilidade do sistema de controle postural e a perda da flexibilidade foram escolhidas para estudo devido à possível relação entre eles. Desse modo, este trabalho teve como objetivo verificar o efeito crônico do treinamento de flexibilidade sobre o controle postural de idosas praticantes de hidroginástica participantes do projeto Prev-Quedas. A amostra foi composta por idosas participantes somente da hidroginástica, selecionadas de forma não probabilística, atendendo aos critérios de elegibilidade. Foram formados dois grupos: o grupo intervenção (GI) composto por 25 idosas que participaram de um programa com exercícios de flexibilidade, além da hidroginástica e o grupo controle (GC), formado por 21 idosas que realizaram apenas a hidroginástica. As idosas foram submetidas às avaliações: antropométrica, da capacidade cognitiva, da força de preensão manual, do controle postural e da amplitude articular máxima. O tratamento estatístico foi feito por meio do software BIOESTAT. 5.2. Foram aplicados testes de comparação e correlação inter e intragrupos. Para analisar a distribuição dos dados foi utilizado o teste de Shapiro-Wilk com o objetivo de designar testes paramétricos e não paramétricos para cada ocasião. Nas comparações foram utilizados os testes t de Student para amostras dependentes e independentes não paramétricas, Mann-Whitney para as independentes paramétricas e Wilcoxon para as amostras dependentes não paramétricas. Para correlacionar os dados foram utilizados o teste de correlação de Pearson para as amostras paramétricas e Spearman para não paramétricas. O nível de significância adotado foi p ≤ 0,05. Os resultados revelaram que o treinamento de flexibilidade associado à prática da hidroginástica, apesar de promoverem aumento na amplitude articular, não acarretou resultados positivos significativos nos indicadores de controle postural em idosas participantes do projeto Prev-Quedas. O grupo controle apresentou melhora significativa da velocidade média, deslocamento total do COP no eixo ântero-posterior, além da capacidade de alcance lateral para ambos os lados e uma redução no tempo de permanência em apoio unipodal. Não foram encontradas correlações significativas entre os valores de Δ goniométricos com aqueles referentes aos testes de controle postural para ambos os grupos. Portanto, o treinamento de flexibilidade associado à prática da hidroginástica não acarretou resultados significativos nos indicadores de controle postural em idosas, embora tenha promovido aumento da amplitude articular máxima nas articulações do quadril e tornozelo. As descobertas expostas sugerem a elaboração de estudos transversais ou longitudinais que abordem o efeito de um programa de exercícios de flexibilidade sobre o controle postural em idosas ativas para contribuir com futuras discussões sobre essa temática. / The aging process involves a series of anatomical, physiological, biomechanical, psychological, emotional and social changes. These changes may lead to impairment performance daily activities and increase the risk of accidents from falls. Currently, the fall in the elderly is a worrying episode due to the high incidence and consequences, affecting their quality of life. Among the many risk factors, the weakness of the balance control system and the loss of flexibility were chosen for study because of the possible relationship between them. Thus, this study aimed to determine the chronic effect of flexibility training on balance control in elderly women engaged in water aerobics participants in Prev-Quedas project. The sample consisted of participants only the elderly water aerobics, selected nonprobabilistically manner, meeting the eligibility criteria. Two groups were formed: the intervention group (IG) consisting of 25 elderly that participated in a program with flexibility exercises, in addition to water aerobics and the control group (CG) consisting of 21 elderly women who underwent only water aerobics. Older underwent evaluation: anthropometric, cognitive ability, handgrip strength, postural balance and maximum range of motion articular. Statistical analysis was performed using the BioStat 5.2 software. Comparison and correlation inter and intra-groups tests were applied. To analyze the distribution of data, the Shapiro-Wilk test aiming to describe parametric and non-parametric tests for each occasion was used. In comparisons the Student t test for non parametric dependent and independent samples was applied, Mann-Whitney test for independent parametric and Wilcoxon tests for non parametric dependent samples were used. To correlate the data the Pearson correlation test were used for parametric samples and Spearman non parametric. The level of significance was p ≤ 0,05. The results revealed that training of flexibility associated with the practice of water aerobics, despite promote increased on the range of motion, not had significant positive results in indicators of postural balance in elderly participants in Prev-Quedas project. The control group showed significant improvement in average speed, total displacement in anteroposterior axis of the COP, and the ability to reach for both lateral sides and a reduction in time spent on one foot. No significant correlations between the values of Δ goniometric those related to postural control tests for both groups were found. Therefore, flexibility training associated with the practice of water aerobics has not resulted in significant indicators of postural balance in older adults, although promoted increased on maximum range of motion in the hip and ankle. The findings suggest the development of exposed transverse or longitudinal studies that address the effect of a program of flexibility exercises on balance control in active elderly to contribute to future discussions on this topic.

Submitted by Fabiana Gonçalves Pinto (benf@ndc.uff.br) on 2015-12-07T12:38:31Z No. of bitstreams: 1 Julianne Quinellato Louro.pdf: 3594581 bytes, checksum: 773d90a7f78e9d690e9646c39b81213c (MD5) / Made available in DSpace on 2015-12-07T12:38:31Z (GMT). No. of bitstreams: 1 Julianne Quinellato Louro.pdf: 3594581 bytes, checksum: 773d90a7f78e9d690e9646c39b81213c (MD5) Previous issue date: 2014 / Mestrado Acadêmico em Ciências do Cuidado em Saúde / Introdução: O equilíbrio, assim como os demais componentes da capacidade física é treinável com a pratica de exercícios físicos, no entanto, há uma falta de padronização do treinamento de equilíbrio. Objetivo: Avaliar a influência de um protocolo específico de exercícios voltados a melhora do equilíbrio em um programa global de atividade física para idosos sobre as variáveis: equilíbrio corporal e força de membros inferiores. Metodologia: Pesquisa do tipo experimental, com a duração de 3 meses. Fizeram parte deste estudo 39 mulheres idosas, sendo 21 no G-Equi e 18 no G-Cont. Para a avaliação foram utilizados questionários para a identificação de possíveis fatores de risco a saúde, variáveis socioeconômicas, nível de atividade física, histórico de quedas, como também, o questionário Mini mental, como exames físicos e testes motores; foram realizadas reavaliações ao final dos 3 meses. Resultados: Após os 3 meses pode-se perceber que o G-Equi apresentou uma diferença significativa entre os resultados dos testes TAFA, o TAFLD, o TAFLE, o TLA e o TC, no entanto, não apresentou para o TU apesar de uma tendência a um melhor desempenho. O G-CONT apresentou diferença significativa para o TLA, tendo as medianas muito próximas para os testes de alcance e TU. Em relação ao resultado da interação entre os grupos pode-se observar que o grupo que realizou a intervenção obteve melhores resultados, tendo diferenças significativas para os testes TAFA, o TAFLD, o TAFLE, e o TC, não apresentando para o TLA e o TU apesar de apresentar melhores resultados nos testes. Para os dados estabilométricos houve uma redução significativa do deslocamento total e da velocidade bidirecional, para o G-Equi com olhos abertos e fechados, e um aumento do deslocamento total e uma redução da velocidade bidirecional para o G-Cont com olhos abertos. Discussão: Os achados revelaram que o treinamento de equilíbrio auxilia na melhora do desempenho do controle postural em idosas, corroborando com a literatura. Conclusão: Os efeitos do treinamento de equilíbrio adicionado em um programa global de exercícios físicos para idosas apresentaram efeitos positivos no equilíbrio corporal e força de membros inferiores, além de evidenciar novas inquietações a respeito da afirmação que uma menor área e oscilação é o que representa maior estabilidade. / Introduction: The balance, as well as other components of physical ability is trainable with the practice of physical activity, however, there is a lack of standardization of balance training. Objective: To evaluate the influence of a specific protocol of exercises aimed at improving balance in a comprehensive physical activity program for seniors on variables: body balance and lower limb strength. Methodology: Survey of experimental type, with a duration of 3 months. This study included 39 elderly women, with 21 in G- Equi and the G- 18 Cont. For the evaluation questionnaires to identify possible risk factors to health, socioeconomic variables, physical activity level, history of falls, as were also used, the Mini Mental questionnaire such as physical exams and testing engines; revaluations were carried out at the end of 3 months. Results: After 3 months it can be seen that the G-Equi showed a significant difference between the results of the tests TAFA the TAFLD the TAFLE, TLA and TC, however, not presented to the TU despite a tendency to better performance. The G- Cont significant difference to TLA, and very close to the testing range and TU medians. Regarding the result of the interaction between the groups can be seen that the group that performed the intervention achieved better results, with significant differences for TAFA tests, TAFLD the TAFLE, and TC, for not presenting the TLA and the TU despite provide better test results. For stabilometric data there was a significant reduction in the total displacement and bidirectional speed for the G- Equi with eyes open and closed, and an increase in total displacement and reduction of bidirectional speed for the G-Cont with open eyes. Discussion: The findings showed that the Balance training helps in improving the performance of postural control in elderly, corroborating with literature. Conclusion: The effects of balance added an overall exercise program for older training had positive effects on body balance and lower limb strength, besides highlighting new concerns regarding the assumption that a shorter swing and is what is most stability.

In North America ice hockey is considered to be the fastest of all teamsports with high demands on leg strength and power. These two factors are crucial for acceleration and the total speed performance during a hockeygame. Skating performance requires a muscle engagement which also occurs during the Y-Balance Test (YBT). Some of the most active muscles during ice skating are biceps femoris, tibialis anterior and vastus medialis , these muscles are also some of the most active muscles during the YBT. The similarities between those two activities enable a possible relationship between skating velocity and YBT. This study investigated the relationship between dynamic postural control and on ice performance which includes 52 meter forward skating. The purpose of this study was to see if there is a significant correlation between skating velocity and the performance on YBT. Methods: 7 male ice hockey players in ages between 18-19 years performed a 52 meter forward skating test and a test for evaluating their dynamic postural control. The method used for measuring the dynamic postural control was the YBT. Results: There was no significant correlation between the YBT longitudinal directions, the total score and 52 meter forward skating. The strongest association (0,570) was shown between the YBT anterior longitudinal direction and 52 meter forward skating. The total score on YBT did not show a significant correlation with 52 meter forward skating, with a correlationcoefficient of 0,251. Conclusion: Due to several management errors during the YBT the results showed no significance. We can not for certain say that there is no significant correlation due to for instance management errors and the deficiency pf power. Future studies are needed to determine if there is a significant correlation between skating velocity and the performance on YBT.

The rollator is a mobility aid commonly used to facilitate balance and mobility for individuals with cardiorespiratory, musculoskeletal, or neurological deficits. Despite its popularity, there are also reports of adverse effects related to walker use linked to increased fall risks. Studies examining the effectiveness and consequences of rollator use have employed standard laboratory-based measurement methods that rely on performing specific tasks within a short time period and under controlled conditions, potentially limiting generalization to mobility in the everyday context. An instrumented rolling walker (iWalker) was developed as an ambulatory measurement tool applicable to the assessment of balance outside of the lab or clinic for assistive device users. The iWalker autonomously collects measurements of the upper and lower limb behaviour related to balance, walker kinematics, and video of the immediate spatial environment. The design and development of the iWalker is first described, followed by two studies characterizing the involvement of the upper limbs for balance in standing and walking that served to address gaps in the literature and evaluate the utility of the upper limb measures. Overall, the upper limbs can become the primary effectors of balancing forces when lower limb capabilities are compromised. When lower limb involvement was experimentally constrained, the upper limbs became the primary effectors of balance control in healthy, young adults. In older adults, individuals demonstrating the highest upper limb usage during walking were associated with the largest reduction in frontal plane stepping parameters (i.e., step width). A third study evaluated the applicability of the iWalker to assess everyday mobility in a series of in-patients recovering from neurological injury (i.e., stroke, traumatic brain injury). Patients demonstrated significantly different upper limb balancing behaviour in everyday situations compared to in-laboratory assessments. Furthermore, the iWalker captured behaviours that may be precursors to falling, such as collisions, stumbling and lifting the assistive device. The implications of these studies on assessing the effectiveness of rollators and feasibility of using the iWalker in follow-up efforts are discussed.

Context: Despite an association between foot structure and the incidence of lower limb injury in sport, few studies have measured the effects of neutral, pronated and supinated foot structures during dynamic activity. Furthermore, despite its widespread use as an injury prevention method, the effects of athletic taping on individuals with pronated and supinated foot structures are unclear. Objectives: To explore whether individuals with pronated and supinated foot structures have poorer lower limb neuromuscular control as measured by postural stability and muscle reaction time in comparison to those with neutral feet. Additionally, the effects of athletic taping on individuals with neutral, pronated and supinated foot structures on aspects of lower limb neuromuscular control are also examined. Subjects: All subjects used in this thesis were aged from 18 – 30 years and took part in at least two hours of exercise each week. Subjects were categorised in to groups according to navicular drop height measures; neutral 5 – 9 mm; pronated ≥ 10 mm; supinated ≤ 4 mm. Methods: Neuromuscular control was analysed in subjects with neutral, pronated and supinated feet using dynamic postural stability and muscular reaction time measures. These measures were then repeated with four athletic taping conditions (arch tape, ankle tape, proprioceptive tape and no-tape) both before and after a period of exercise. Results: Individuals with pronated and supinated foot structures were shown to have reduced postural stability in comparison to those with neutral foot structures during some dynamic tasks. Pronated and supinated foot structures also resulted in slower muscle reaction times in comparison to those with neutral feet during a tilt platform perturbation. No differences were identified between dominant and non-dominant limbs on subjects with neutral, pronated or supinated foot structures; however the high incidence of foot structure asymmetry did appear to result in differences between contralateral limbs in both postural stability and reaction time parameters. Arch and ankle taping resulted in increased neuromuscular control after application, yet these effects diminished after a period of exercise. Conclusions: The results of this thesis provide evidence to suggest that foot structure does affect lower limb neuromuscular control as measured by postural stability and muscle reaction time. In addition athletic taping has been shown to affect neuromuscular control on subjects with neutral, pronated and supinated foot structures both before and after exercise. These findings may have wide implications in sport where individuals with pronated and supinated feet may be more susceptible to injury in comparison to those with neutral feet.

Postural distortion of human bite marks on skin occurs when photographing a bite mark in a body position other than the position of the body at the time of biting. Postural distortion in the bite mark may introduce significant changes in both the shape and size of the recorded marks. As a result, the analysis of the marks may be hindered and a proper comparison between the bite mark and the causal dentition may be precluded. Therefore, a method by which postural distortion in a bite mark photographic record can be evaluated and eliminated with minimal operator subjectivity is required. This study describes the development of an objective technique for evaluating postural distortion in bite mark photographic records and for minimising postural distortion during photography of bite marks. The source for developing these techniques was provided by digitally analysing the symmetry of dental arches in a defined population including males and females (236 subjects) whose ages ranged between 20 and 30 years. The analysis resulted in quantifying a mathematical relationship between the biting edges of each homologous pair of the anterior teeth and specified reference lines. The validity of the analytical method of dental arch symmetry is discussed. The developed techniques were applied to posturally distorted (test) bite marks. The results demonstrate the validity of the developed techniques in determining postural distortion and recording correct images (shown to resemble the biters dentition) of the test bites. Suggestions for further work are proposed.

Background: Concussion assessments rely on a multifaceted approach where evaluation of balance and postural control plays an important role. Following a concussion, 67% of individuals report dizziness as a persistent symptom and 30% experience balance impairments. Studies incorporating the common Balance Error Scoring System (BESS) tool suggest that these impairments return to pre-injury baselines within ten days of incident. In contrast, however, studies incorporating more advanced posturography methods observe significant differences in balance up to one year following injury. While the BESS is consistently associated with low sensitivity and poor reliability scores, advanced posturography systems using force plates are not practical or accessible in most recreational sports environments. Recently, the Wii Balance Board (WBB) has been identified as a potential force plate proxy. Research confirms that the WBB is both valid and reliable in collecting center of pressure data. Thus, the WBB may be useful for investigating post-concussion balance deficits. Objective: The purpose of this study was to investigate the potential utility of a customized WBB program to assess postural balance in an athletic population. The study aimed to assess change in postural balance using the clinical BESS and WBB assessment tools to evaluate balance at fixed intervals during a regular athletic season and following concussion. Design: Prospective partial cohort. Methods: Balance was assessed at baseline, mid-, and post-season. Individuals who sustained a concussion during the study period were further assessed weekly for four weeks post-injury. Results: No significant differences were observed in raw BESS scores across regular season or post-concussion time points. In contrast, significant differences in several WBB outcome measures were observed. In the single stance condition, COPML worsened by 24% and COPT worsened by 9% between baseline and post-season time points (p=.002 and p=.007). In contrast, participants improved by 14% on a timed dynamic task (p=.003) between baseline and post-season time points. Following concussion, only the WBB dynamic outcome measures were found to be statistically significant. A positive trend was observed post-concussion, suggesting that a learning effect exists with the dynamic WBB program. Conclusion: Study results emphasize the importance of considering the progression of athletic season when interpreting baseline and post-concussion balance measurements. Study results support the use of a quantitative balance assessment, such as with a WBB, to improve measurement of static and dynamic postural balance. / Graduate / 0566 / hilarymcullen@gmail.com

The purpose of the current research was to examine how a novel balance task is learnt by individuals with a mature neurological system, and to investigate the responses of experienced hand balancers to mechanical and sensory perturbations. Balance in each posture was assessed by various techniques, including: traditional measures of centre of pressure, nonlinear time series analysis of centre of pressure, estimates of feedback time delay from cross correlations and delayed regression models, and calculation of small, medium, and large movement corrections. Data from this study suggests that the best balance metric for distinguishing between each of the balance conditions was the traditional balance measure of sway velocity. However, sway velocity cannot provide any further information on the underlying process of balance. Nonlinear measures of balance offer insight into the underlying deterministic processes that control balance, offering measures of system determinism, complexity, and predictability. Assessments of feedback time delay and movement corrections provide both an insight into the control of posture and help distinguish one condition from another. Both feedback time delay and movement corrections and magnitudes may be used simultaneously to delve further into the control of posture. Delayed regression models seem to be an appropriate and useful tool for estimating feedback time delays during balance. Findings support the use of the third term in the adapted regression model as a means of estimating the effect of passive stiffness on feedback time delay. Generally, with increased duration in handstand subjects displayed reduced sway as measured by traditional measures of balance. A more marked change in nonlinear measures of balance can be seen, with quicker reductions in variance for some nonlinear measures of balance than in the traditional measures. It may be that more pronounced changes in nonlinear measures represent changes in the subjects underlying process of postural control, whereas less pronounced changes in traditional measures relate more to their general ability or performance in the balance task.

Mémoire numérisé par la Direction des bibliothèques de l'Université de Montréal.

Title: The Effect of Kinesiotaping on Postural Stabilization in Patients after ACL Reconstruction Aim: The main aim of the thesis was to evaluate, whether postural stabilization of patients after ACL reconstruction followed by kinesiotaping of the knee joint will be improved or decreased. Also the difference in postural stability of operated and un-operated lower extremity was evaluated. Methods: The thesis included 10 subjects. Each of them was from 4 to 6 weeks after ACL reconstruction, BTB technique. All subjects regularly attended group exercise in CLPA s.r.o. Every subject completed five measurements of postural somatooscilography, before exercise with kinesiotape and without, after exercise completed with kinesiotape, and after five days before and after exercise without kinesiotape. The values were saved by Microswing 6.0 and analyzed by Posturomed Commander. Then the values were evaluated by Microsoft Office Excel and statistic procedures were done by XLSTAT. Results: The measurement confirmed an effect of kinesiotaping on improvement of postural stabilization. Immediately after the application of the tape five out of seven parameters were improved. Participating in the exercise unit revealed an improving trend of postural stabilization, in comparison with the results before exercise. There...