Diss.--Göteborg, 2000. / Résumé en anglais. Bibliogr. p. 315-321.

Made available in DSpace on 2014-06-11T19:28:59Z (GMT). No. of bitstreams: 0 Previous issue date: 2011-02-28Bitstream added on 2014-06-13T19:37:40Z : No. of bitstreams: 1 santos_rm_me_bauru.pdf: 830347 bytes, checksum: e0bae54e1790df70aaa93108fa369c07 (MD5) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / A postura sentada promovo diversas alterações nas estruturas músculo-esquelética, na circulação dos membros inferiores e no conforto dos membros superiores. Tais alterações produzem consequencias no processo de ensino-aprendizagem no âmbito escolar. Esta pesquisa buscou investigar os efeitos do procedimento de Reforço de Verbalização (RV) e Treino de Correspondência (TC) sobre a postura sentada em escolares e sobre seus relatos acerca dos posicionamentos dos pés, coluna lombar, coluna cervical e antebraços em três sequencias (Dizer-Fazer, Fazer-Dizer e Dizer-Fazer-Dizer). Participaram do estudo 9 alunos do 4º ano do ensino fundamental de uma escola pública do estado de São Paulo, com alturas semelhantes, que foram divididos em três grupos: Dizer-Fazer, (DF), Fazer-Dizer, (FD) e Dizer-Fazer-Dizer (DFD) com três alunos em cada grupo. O procedimento experimental compreendeu 4 condições experimentais: Linha de Base 1, Reforço de Verbalização (as respostas verbais corretas emitidas pelos participantes eram consequenciadas positivamente pela pesquisadora), Treino de Correspondência (a emissão das respostas verbais e dos posicionamentos corretos dos participantes eram consequenciados positivamente) e Linha de Base 2. Para verificar a correspondência entre o comportamento verbal e o não-verbal foi analisada a frequencia das respostas verbais corretas apresentadas pelos alunos em relação aos registros dos posicionamentos apresentados em relação a cada segmento corporal selecionado. Durante a Fase RV a frequencia da verbalização correta aumentou para todos os participantes dos três grupos, e os posicionamentos dos segmentos corporais pés e coluna lombar aumentaram para os participantes dos grupos DF e FD. / The sitting posture promotes several changes in the musculoskeletal structures, the movement of the lower limbs and in the comfort of the upper limbs. These effects have consequences in the teaching and learning in schools. This research investigates the effects of the procedure Boost Verbosity (VR) training and correspondence (TC) on sitting posture in children and about his statement regarding the positions of the feet, spine, cervical spine and forearm in three sequences (say-Do, Do-say and Do-Say-Say). Study participants were nine students in the 4th grade of elementary education at a public school in the state of Sao Paulo, with similar heights, which were divided into three groups: Say-Do, (DF), Do-Tell (FD) and Say-Do-Telling (DFD) with three students in each group. The experimental prodedure consisted of four experimental conditions: baseline 1, Strengthening of verbalization (the correct verbal responses issued by the participants were positive consequences for the researcher), Correspondence Training (the emission of verbal responses and the correct positioning of the participants were positive consequences) and Baseline 2. To verify the correspondence between the verbal and nonverbal analyzed the frequency of correct verbal responses made by students in relation to records of the positions presented in relation to each body segment selected. During Phase RV verbalization correct frequency increased for all three groups of participants, and positions of body segments, Iegs and lumbar spine increased for participants in the FD groups. In Phase CT correct verbalization was maintained by all participants of all groups and increased the correct position all body segments and hence the correspondence between the verbal and nonverbal behavior. In LB2 correct verbalization was maintained in all groups and there was a small decrease in matching segments of the cervical spine for all groups and for groups of forearms and DF DFD.

Orientador: Maria Regina Cavalcante / Banca: Luis Carlos Paschoarelli / Banca: Jair Lopes Junior / Resumo: A postura sentada promovo diversas alterações nas estruturas músculo-esquelética, na circulação dos membros inferiores e no conforto dos membros superiores. Tais alterações produzem consequencias no processo de ensino-aprendizagem no âmbito escolar. Esta pesquisa buscou investigar os efeitos do procedimento de Reforço de Verbalização (RV) e Treino de Correspondência (TC) sobre a postura sentada em escolares e sobre seus relatos acerca dos posicionamentos dos pés, coluna lombar, coluna cervical e antebraços em três sequencias (Dizer-Fazer, Fazer-Dizer e Dizer-Fazer-Dizer). Participaram do estudo 9 alunos do 4º ano do ensino fundamental de uma escola pública do estado de São Paulo, com alturas semelhantes, que foram divididos em três grupos: Dizer-Fazer, (DF), Fazer-Dizer, (FD) e Dizer-Fazer-Dizer (DFD) com três alunos em cada grupo. O procedimento experimental compreendeu 4 condições experimentais: Linha de Base 1, Reforço de Verbalização (as respostas verbais corretas emitidas pelos participantes eram consequenciadas positivamente pela pesquisadora), Treino de Correspondência (a emissão das respostas verbais e dos posicionamentos corretos dos participantes eram consequenciados positivamente) e Linha de Base 2. Para verificar a correspondência entre o comportamento verbal e o não-verbal foi analisada a frequencia das respostas verbais corretas apresentadas pelos alunos em relação aos registros dos posicionamentos apresentados em relação a cada segmento corporal selecionado. Durante a Fase RV a frequencia da verbalização correta aumentou para todos os participantes dos três grupos, e os posicionamentos dos segmentos corporais pés e coluna lombar aumentaram para os participantes dos grupos DF e FD. / Abstract: The sitting posture promotes several changes in the musculoskeletal structures, the movement of the lower limbs and in the comfort of the upper limbs. These effects have consequences in the teaching and learning in schools. This research investigates the effects of the procedure Boost Verbosity (VR) training and correspondence (TC) on sitting posture in children and about his statement regarding the positions of the feet, spine, cervical spine and forearm in three sequences (say-Do, Do-say and Do-Say-Say). Study participants were nine students in the 4th grade of elementary education at a public school in the state of Sao Paulo, with similar heights, which were divided into three groups: Say-Do, (DF), Do-Tell (FD) and Say-Do-Telling (DFD) with three students in each group. The experimental prodedure consisted of four experimental conditions: baseline 1, Strengthening of verbalization (the correct verbal responses issued by the participants were positive consequences for the researcher), Correspondence Training (the emission of verbal responses and the correct positioning of the participants were positive consequences) and Baseline 2. To verify the correspondence between the verbal and nonverbal analyzed the frequency of correct verbal responses made by students in relation to records of the positions presented in relation to each body segment selected. During Phase RV verbalization correct frequency increased for all three groups of participants, and positions of body segments, Iegs and lumbar spine increased for participants in the FD groups. In Phase CT correct verbalization was maintained by all participants of all groups and increased the correct position all body segments and hence the correspondence between the verbal and nonverbal behavior. In LB2 correct verbalization was maintained in all groups and there was a small decrease in matching segments of the cervical spine for all groups and for groups of forearms and DF DFD. / Mestre

O presente estudo investigou as mudanças relacionadas à idade nos ajustes posturais compensatórios em crianças com e sem Desordem Coordenativa Desenvolvimental (DCD). Os ajustes posturais compensatórios foram investigados em 105 crianças (5-12 anos de idade) que foram selecionadas a partir de 538 crianças no sul do Brasil. As crianças com DCD foram definidas como aquelas com escores abaixo do 5º percentil no Teste Movement ABC. As crianças com desenvolvimento típico (DT) foram aquelas cujos escores no teste foram acima do 30º percentil (52 crianças). Os sujeitos foram solicitados a permanecerem em pé ereto sobre uma plataforma de força e a executar um movimento rápido alvo direcionado com o membro superior direito. O tempo de movimento e os erros absolutos do movimento do braço e também a amplitude e direção das mudanças do centro de pressão foram mensuradas. O resultado mostrou mudanças relacionadas à idade nos ajustes posturais compensatórios e, tempo de movimento, significativos em ambos os grupos. As crianças com DT mostraram mudanças com a idade significativas sobre a direção e amplitude do centro de pressão (COPy), sugerindo que eles melhoram suas habilidades para ajustar o equilíbrio quando realizando um movimento voluntário do membro superior com a idade, pelo uso do seu feedback. Crianças com DCD mostraram grandes amplitudes médio-laterais e tempo de movimento, quando comparadas com as crianças com DT. Uma correlação forte e positiva foi encontrada entre a amplitude do centro de pressão e o tempo de movimento em crianças com DCD sugerindo que os atrasos no movimento, frequentemente observados na criança com DCD, poderia ser causada por déficits posturais. Nós concluímos que a tendência desenvolvimental dos ajustes posturais compensatórios nas crianças com DCD é semelhante à criança com DT. / The present study investigated age-related changes of compensatory postural adjustments in children with and without Developmental Coordination Disorder (DCD). Compensatory postural adjustments were investigated in 105 children (5-12 years old) screened from 538 children in the south of Brazil. Children with DCD were defined as those with scores at or below the 5th (53 Children) percentile on Movement ABC Test. Typically developing children (TD) were those whose scores on the test were above the 30th percentile (52 children). Subjects were asked to stand upright and still on the force platform and perform a quick goal movement directed with the right superior limb. Movement time and absolute error of the arm movement and also amplitude and direction changes of the center of pressure were measured. The results showed significant age-related changes in the compensatory postural adjustments and movement time in both groups. TD children showed significant age-related changes on direction and amplitude of center of pressure (COPy), suggesting that they improve their ability to adjust their balance when performing an arm voluntary movements with the age by using their feedback. Children with DCD showed larger medium-lateral amplitudes and movement times as compared with TD children. A positive and well correlation found between center of pressure amplitude and movement time in children with CD suggests that the movements delays, often observed in children with DCD, could be caused by postural deficits. We conclude that the development trend of compensatory postural adjustments in children with DCD is similar to TD children.

This dissertation aimed to investigate the relationship between posture and reaching in both healthy and pathological conditions, approaching the trunk as a multi-segmented structure. For this purpose, neuromuscular and kinematic profiles were recorded from trunk and arm during seated reaches providing mid-rib vs pelvic levels of trunk support. Healthy adults with mature postural and reaching abilities displayed invariant arm kinematics during the reach. However, participants displayed increased anticipatory control and earlier activation of cervical muscles with mid-rib support. Participants also presented increased compensatory responses of paraspinal muscles when responding to the increased trunk balance demands with pelvic support. Children with moderate/severe cerebral palsy (CP) cannot maintain an upright sitting position and thus cannot create a stable postural frame around which upper limb movements are planned and executed. A second set of studies examined postural and reaching characteristics in these children, while applying axillae, mid-rib or pelvic levels of support. Participants were classified according to their intrinsic level of trunk control as mild, moderate and severe. With higher levels of support children with moderate to severe impairments in trunk control showed improvements of head and trunk control along with enhanced reaching performance. Participants with mild trunk dysfunction were able to sit independently and thus did not demonstrate significant changes in postural and reaching proficiency across levels of external trunk support. Electromyographic profiles were more variable depending on the severity of intrinsic trunk control. Overall, participants in the mild group presented more refined timing mechanisms for both anticipatory (closer to reaching onset) and compensatory (reduced latency) postural adjustments during the reach across all levels of support. Participants in the moderate group displayed earlier muscle onsets and more efficient arm/trunk muscle amplitudes with higher levels of support. Participants in the severe group showed very limited capability of anticipatory control of paraspinal muscles, delayed muscle onsets and variable muscle amplitudes across levels of support. These results emphasize the complex neuro-anatomical nature of trunk control during reaching. Also, they highlight that inefficient postural control while sitting significantly impacts children with CP and trunk dysfunction. This dissertation includes previously unpublished co-authored material.

This dissertation aimed to investigate the relationship between posture and reaching in both healthy and pathological conditions, approaching the trunk as a multi-segmented structure. For this purpose, neuromuscular and kinematic profiles were recorded from trunk and arm during seated reaches providing mid-rib vs pelvic levels of trunk support. Healthy adults with mature postural and reaching abilities displayed invariant arm kinematics during the reach. However, participants displayed increased anticipatory control and earlier activation of cervical muscles with mid-rib support. Participants also presented increased compensatory responses of paraspinal muscles when responding to the increased trunk balance demands with pelvic support. Children with moderate/severe cerebral palsy (CP) cannot maintain an upright sitting position and thus cannot create a stable postural frame around which upper limb movements are planned and executed. A second set of studies examined postural and reaching characteristics in these children, while applying axillae, mid-rib or pelvic levels of support. Participants were classified according to their intrinsic level of trunk control as mild, moderate and severe. With higher levels of support children with moderate to severe impairments in trunk control showed improvements of head and trunk control along with enhanced reaching performance. Participants with mild trunk dysfunction were able to sit independently and thus did not demonstrate significant changes in postural and reaching proficiency across levels of external trunk support. Electromyographic profiles were more variable depending on the severity of intrinsic trunk control. Overall, participants in the mild group presented more refined timing mechanisms for both anticipatory (closer to reaching onset) and compensatory (reduced latency) postural adjustments during the reach across all levels of support. Participants in the moderate group displayed earlier muscle onsets and more efficient arm/trunk muscle amplitudes with higher levels of support. Participants in the severe group showed very limited capability of anticipatory control of paraspinal muscles, delayed muscle onsets and variable muscle amplitudes across levels of support. These results emphasize the complex neuro-anatomical nature of trunk control during reaching. Also, they highlight that inefficient postural control while sitting significantly impacts children with CP and trunk dysfunction. This dissertation includes previously unpublished co-authored material.

Tradicionalmente, a utilização de questionários como instrumento avaliativo da postura corporal nas Atividades de Vida Diária (AVD’s) tem sido amplamente divulgada, seja em estudos descritivos, transversais e longitudinais, ou experimentais, como os programas educativos e as Escolas Posturais. Não obstante, o questionário é baseado em auto-relato, sendo dependente da percepção e do nível cognitivo do avaliado, o que pode resultar em um viés nos resultados, principalmente se os avaliados forem crianças e adolescentes. Deste modo, são necessárias metodologias válidas e reprodutíveis capazes de avaliar a postura corporal dinâmica a partir de observações e filmagens, minimizando o viés resultante do auto-relato. Procurando identificar os instrumentos de avaliação da postura dinâmica já publicados na literatura foi realizada uma busca sistemática de artigos em bases de dados (Scopus, ScienceDirect, PubMed, Scielo) publicados a partir da década de 1980 e no Banco de Teses e Dissertações da Capes. Os instrumentos propostos deveriam preencher os seguintes critérios: (a) avaliar a postura corporal durante a realização de AVD’s; (b) utilizar critérios pré-definidos de avaliação; e (c) avaliar a postura a partir de observação ou a partir de filmagem. Foram identificados oito artigos originais que apresentam instrumentos de avaliação da postura dinâmica, avaliando a execução de AVD’s por meio de critérios biomecânicos pré-definidos, por meio de escalas numéricas, sendo que, destes, apenas quatro foram elaborados especificamente com o propósito de avaliar a execução de AVD’s de escolares. Em geral, considera-se que esses instrumentos apresentem algumas limitações metodológicas, tais como carecerem de procedimentos de validação e de reprodutibilidade. O CAPD, desenvolvido a partir de uma pesquisa de campo e em publicações científicas, possibilita avaliar a postura corporal de nove AVD’s: carregar sacolas e mochila escolar; escrever; pegar objeto do solo e transportá-lo; utilizar o computador portátil e de mesa; sentar em um banco; e ao dormir. Os procedimentos de validade e reprodutibilidade do CAPD consistiram na sua: (a) submissão a sete especialistas, para avaliação científica do conteúdo; (b) determinação da reprodutibilidade inter e intra-avaliador e teste-reteste, a partir da filmagem de 112 escolares; (c) validação de constructo, determinada a partir da comparação dos resultados entre 10 universitários e os escolares. A análise estatística foi realizada no Software SPSS18.0, por meio do Coeficiente de Correlação Intra-Classe (ICC), do Coeficiente Kappa e do teste U de Mann Whitney (α=0,05). Os resultados de cada postura, separadamente, demonstraram que a reprodutibilidade intraavaliador foi classificada como excelente (ICC>0,75) e que a reprodutibilidade inter-avaliador e testereteste foram classificadas como moderada (ICC de 0,4 a 0,75) e excelente (ICC>0,75). Os resultados do Coeficiente Kappa, na avaliação dos critérios de pontuação, demonstraram que (1) a reprodutibilidade intra-avaliador apresentou resultados superiores em comparação à reprodutibilidade inter-avaliador e teste-reteste, e que (2) as posturas ao carregar sacolas, transportar mochila escolar, pegar objeto do solo e transportá-lo e ao dormir apresentaram resultados superiores em comparação às posturas sentadas. Os resultados do teste U de Mann Whitney demonstraram que os acadêmicos apresentaram pontuações significativamente superiores aos escolares para todas as posturas, exceto na postura ao transportar mochila escolar. A partir desses achados, conclui-se que o CAPD é um instrumento válido e reprodutível que pode ser utilizado na avaliação da postura nas AVD’s de escolares. / Traditionally, the use of questionnaires as an evaluation tool of corporal posture in Activities of Daily Living (ADL’s) has been widely spread in descriptive, transversal and longitudinal, or experimental studies as well as educational programs and Back Schools. Notwithstanding, these questionnaires are based on people’s account of their activities thus depending on these people’s perception and cognitive level which may alter the results, especially if the public being evaluated is mainly of children and teenagers. In this way, it is necessary to have valid methodologies that are capable of reproducing and evaluating the corporal dynamic posture from observations and footage, minimizing the altered results that may come out in people’s self-account of facts. In order to identify the evaluation tools of dynamic posture already published, it was carried out a systemic search of papers on the matter on database sites such as Scopus, ScienceDirect, PubMed and Scielo, published from 1980 on, and also on the database of thesis and dissertation of Capes. The tools suggested should meet the following criteria: (a) evaluate the corporal posture during ADL’s; (b) use pre-defined evaluation criteria of dynamic posture; and (c) evaluate posture from direct observation or through footage. Eight original papers that present tools for the analysis of dynamic posture were identified. These papers analysis the ADL’s through pre-defined biochemical criteria, through numerical scale; however, only four tools were elaborated aiming at assessing school students’ ADL’s. In general, it is considered that the tools used present some methodological limitations such as validation and reproducibility procedures. In this sense, aiming at contributing to fill in this gap, the present study has as its objectives to suggest the use of Analysis of Dynamic Posture Apparatus (ADPA) as an assessment tool of corporal posture adopted in DLA’s common among school students in order to determine its validity and reproducibility. ADPA, developed during field researches and scientific publications, allows the evaluation of nine ADL’s corporal postural during activities such as carrying bags and school bags, writing, picking up object from the floor and carrying it, using a computer both laptop and desktop, sitting on a bench, and sleeping. The procedures of validity and reproducibility of ADPA consist in its: (a) submission to seven specialists for content validity; (b) determination of reproducibility inter and intra-evaluator and test-retest through footage of 112 school students; (c) construct validity, determined from the comparison of results among 10 university students and school students. The statistical analysis was carried out on Software SPSS 18.0, through the Intraclass Correlation Coefficient (ICC), Kappa Coefficient and the U de Mann Whitney test (α=0,05). The results of each posture, separately, show that the reproducibility intra-evaluator was classified as excellent (ICC>0,75) and that the reproducibility inter-evaluator and test-retest were classified as moderate (ICC from 0,4 to 0,75) and excellent (ICC>0,75). The results of Kappa Coefficient, in the evaluation of scoring criteria, show that (1) the reproducibility of intra-evaluator showed results that are superior in comparison to the reproducibility inter-evaluator and test-retest; and (2) the posture when carrying bags, school bags, picking up objects from the floor and carrying them and sleeping show results superior in comparison to sitting postures. The results of U de Mann Whitney test show that university students have significantly superior scores to all of the postures, except the one of carrying a school bag. Taking these findings into consideration, it is possible to conclude that APDA has validity and reproducibility and that it is possible to be used in the assessment of posture in school students’ ADL’s.

Tradicionalmente, a utilização de questionários como instrumento avaliativo da postura corporal nas Atividades de Vida Diária (AVD’s) tem sido amplamente divulgada, seja em estudos descritivos, transversais e longitudinais, ou experimentais, como os programas educativos e as Escolas Posturais. Não obstante, o questionário é baseado em auto-relato, sendo dependente da percepção e do nível cognitivo do avaliado, o que pode resultar em um viés nos resultados, principalmente se os avaliados forem crianças e adolescentes. Deste modo, são necessárias metodologias válidas e reprodutíveis capazes de avaliar a postura corporal dinâmica a partir de observações e filmagens, minimizando o viés resultante do auto-relato. Procurando identificar os instrumentos de avaliação da postura dinâmica já publicados na literatura foi realizada uma busca sistemática de artigos em bases de dados (Scopus, ScienceDirect, PubMed, Scielo) publicados a partir da década de 1980 e no Banco de Teses e Dissertações da Capes. Os instrumentos propostos deveriam preencher os seguintes critérios: (a) avaliar a postura corporal durante a realização de AVD’s; (b) utilizar critérios pré-definidos de avaliação; e (c) avaliar a postura a partir de observação ou a partir de filmagem. Foram identificados oito artigos originais que apresentam instrumentos de avaliação da postura dinâmica, avaliando a execução de AVD’s por meio de critérios biomecânicos pré-definidos, por meio de escalas numéricas, sendo que, destes, apenas quatro foram elaborados especificamente com o propósito de avaliar a execução de AVD’s de escolares. Em geral, considera-se que esses instrumentos apresentem algumas limitações metodológicas, tais como carecerem de procedimentos de validação e de reprodutibilidade. O CAPD, desenvolvido a partir de uma pesquisa de campo e em publicações científicas, possibilita avaliar a postura corporal de nove AVD’s: carregar sacolas e mochila escolar; escrever; pegar objeto do solo e transportá-lo; utilizar o computador portátil e de mesa; sentar em um banco; e ao dormir. Os procedimentos de validade e reprodutibilidade do CAPD consistiram na sua: (a) submissão a sete especialistas, para avaliação científica do conteúdo; (b) determinação da reprodutibilidade inter e intra-avaliador e teste-reteste, a partir da filmagem de 112 escolares; (c) validação de constructo, determinada a partir da comparação dos resultados entre 10 universitários e os escolares. A análise estatística foi realizada no Software SPSS18.0, por meio do Coeficiente de Correlação Intra-Classe (ICC), do Coeficiente Kappa e do teste U de Mann Whitney (α=0,05). Os resultados de cada postura, separadamente, demonstraram que a reprodutibilidade intraavaliador foi classificada como excelente (ICC>0,75) e que a reprodutibilidade inter-avaliador e testereteste foram classificadas como moderada (ICC de 0,4 a 0,75) e excelente (ICC>0,75). Os resultados do Coeficiente Kappa, na avaliação dos critérios de pontuação, demonstraram que (1) a reprodutibilidade intra-avaliador apresentou resultados superiores em comparação à reprodutibilidade inter-avaliador e teste-reteste, e que (2) as posturas ao carregar sacolas, transportar mochila escolar, pegar objeto do solo e transportá-lo e ao dormir apresentaram resultados superiores em comparação às posturas sentadas. Os resultados do teste U de Mann Whitney demonstraram que os acadêmicos apresentaram pontuações significativamente superiores aos escolares para todas as posturas, exceto na postura ao transportar mochila escolar. A partir desses achados, conclui-se que o CAPD é um instrumento válido e reprodutível que pode ser utilizado na avaliação da postura nas AVD’s de escolares. / Traditionally, the use of questionnaires as an evaluation tool of corporal posture in Activities of Daily Living (ADL’s) has been widely spread in descriptive, transversal and longitudinal, or experimental studies as well as educational programs and Back Schools. Notwithstanding, these questionnaires are based on people’s account of their activities thus depending on these people’s perception and cognitive level which may alter the results, especially if the public being evaluated is mainly of children and teenagers. In this way, it is necessary to have valid methodologies that are capable of reproducing and evaluating the corporal dynamic posture from observations and footage, minimizing the altered results that may come out in people’s self-account of facts. In order to identify the evaluation tools of dynamic posture already published, it was carried out a systemic search of papers on the matter on database sites such as Scopus, ScienceDirect, PubMed and Scielo, published from 1980 on, and also on the database of thesis and dissertation of Capes. The tools suggested should meet the following criteria: (a) evaluate the corporal posture during ADL’s; (b) use pre-defined evaluation criteria of dynamic posture; and (c) evaluate posture from direct observation or through footage. Eight original papers that present tools for the analysis of dynamic posture were identified. These papers analysis the ADL’s through pre-defined biochemical criteria, through numerical scale; however, only four tools were elaborated aiming at assessing school students’ ADL’s. In general, it is considered that the tools used present some methodological limitations such as validation and reproducibility procedures. In this sense, aiming at contributing to fill in this gap, the present study has as its objectives to suggest the use of Analysis of Dynamic Posture Apparatus (ADPA) as an assessment tool of corporal posture adopted in DLA’s common among school students in order to determine its validity and reproducibility. ADPA, developed during field researches and scientific publications, allows the evaluation of nine ADL’s corporal postural during activities such as carrying bags and school bags, writing, picking up object from the floor and carrying it, using a computer both laptop and desktop, sitting on a bench, and sleeping. The procedures of validity and reproducibility of ADPA consist in its: (a) submission to seven specialists for content validity; (b) determination of reproducibility inter and intra-evaluator and test-retest through footage of 112 school students; (c) construct validity, determined from the comparison of results among 10 university students and school students. The statistical analysis was carried out on Software SPSS 18.0, through the Intraclass Correlation Coefficient (ICC), Kappa Coefficient and the U de Mann Whitney test (α=0,05). The results of each posture, separately, show that the reproducibility intra-evaluator was classified as excellent (ICC>0,75) and that the reproducibility inter-evaluator and test-retest were classified as moderate (ICC from 0,4 to 0,75) and excellent (ICC>0,75). The results of Kappa Coefficient, in the evaluation of scoring criteria, show that (1) the reproducibility of intra-evaluator showed results that are superior in comparison to the reproducibility inter-evaluator and test-retest; and (2) the posture when carrying bags, school bags, picking up objects from the floor and carrying them and sleeping show results superior in comparison to sitting postures. The results of U de Mann Whitney test show that university students have significantly superior scores to all of the postures, except the one of carrying a school bag. Taking these findings into consideration, it is possible to conclude that APDA has validity and reproducibility and that it is possible to be used in the assessment of posture in school students’ ADL’s.

O presente estudo investigou as mudanças relacionadas à idade nos ajustes posturais compensatórios em crianças com e sem Desordem Coordenativa Desenvolvimental (DCD). Os ajustes posturais compensatórios foram investigados em 105 crianças (5-12 anos de idade) que foram selecionadas a partir de 538 crianças no sul do Brasil. As crianças com DCD foram definidas como aquelas com escores abaixo do 5º percentil no Teste Movement ABC. As crianças com desenvolvimento típico (DT) foram aquelas cujos escores no teste foram acima do 30º percentil (52 crianças). Os sujeitos foram solicitados a permanecerem em pé ereto sobre uma plataforma de força e a executar um movimento rápido alvo direcionado com o membro superior direito. O tempo de movimento e os erros absolutos do movimento do braço e também a amplitude e direção das mudanças do centro de pressão foram mensuradas. O resultado mostrou mudanças relacionadas à idade nos ajustes posturais compensatórios e, tempo de movimento, significativos em ambos os grupos. As crianças com DT mostraram mudanças com a idade significativas sobre a direção e amplitude do centro de pressão (COPy), sugerindo que eles melhoram suas habilidades para ajustar o equilíbrio quando realizando um movimento voluntário do membro superior com a idade, pelo uso do seu feedback. Crianças com DCD mostraram grandes amplitudes médio-laterais e tempo de movimento, quando comparadas com as crianças com DT. Uma correlação forte e positiva foi encontrada entre a amplitude do centro de pressão e o tempo de movimento em crianças com DCD sugerindo que os atrasos no movimento, frequentemente observados na criança com DCD, poderia ser causada por déficits posturais. Nós concluímos que a tendência desenvolvimental dos ajustes posturais compensatórios nas crianças com DCD é semelhante à criança com DT. / The present study investigated age-related changes of compensatory postural adjustments in children with and without Developmental Coordination Disorder (DCD). Compensatory postural adjustments were investigated in 105 children (5-12 years old) screened from 538 children in the south of Brazil. Children with DCD were defined as those with scores at or below the 5th (53 Children) percentile on Movement ABC Test. Typically developing children (TD) were those whose scores on the test were above the 30th percentile (52 children). Subjects were asked to stand upright and still on the force platform and perform a quick goal movement directed with the right superior limb. Movement time and absolute error of the arm movement and also amplitude and direction changes of the center of pressure were measured. The results showed significant age-related changes in the compensatory postural adjustments and movement time in both groups. TD children showed significant age-related changes on direction and amplitude of center of pressure (COPy), suggesting that they improve their ability to adjust their balance when performing an arm voluntary movements with the age by using their feedback. Children with DCD showed larger medium-lateral amplitudes and movement times as compared with TD children. A positive and well correlation found between center of pressure amplitude and movement time in children with CD suggests that the movements delays, often observed in children with DCD, could be caused by postural deficits. We conclude that the development trend of compensatory postural adjustments in children with DCD is similar to TD children.

Objetivos: analisar a postura corporal em pacientes disfônicos e correlacioná-los com indivíduos sem alteração de voz, a fim de estabelecer novos recursos terapêutico para reabilitar o portador de disfonia. Método: estudo prospectivo. Foram avaliados 43 indivíduos (23 disfônicos e 20 sem alteração de voz) do sexo feminino,com idade entre 18 e 40 anos ,sem alterações neurológicas ,respiratórias e reumáticas. Todos os pacientes foram encaminhado pelo serviço de Otorrinolaringologia da Escola Paulista de Medicina ( UNIFESP- EPM),após anamnese, exame do otorrinolaringologista e laringoscopia ,tendo como diagnostico de disfonia funcional ou organofuncional. Nessa população foi avaliado: 1- Postura corporal in loco, 2 – Documentação fotográfica, 3 – Exame Eletromiografia, 4 – Questionário das algias. Resultados: não houve diferença estatisticamente significante em relação à queixa,porem foi encontrado um numero maior de tensão muscular e dor na região cervical, onde se encontra situado a laringe, nos portadores de disfonia. Na avaliação postural, os indivíduos disfônicos apresentarão assimetria de ombros, alteração no posicionamento da escapula, retificação com anteriorização da região cervical em relação ao grupo controle. Nos resultados da eletromiografia houve aumento das atividades nos músculos supra-hióideo em emissão prolongada, controlada e deglutição. Nos músculos infra-hióideo houve alteração no traçado eletromiógrafico na emissão prolongada. Conclusão: pode- se concluir que o estudo mostra a existência da correlação positiva entre indivíduos portadores de disfonia e alteração na postura, baseado nas diferenças dos achados clínicos e medidas eletromiográficas. / Objectives: This study analyzed the body posture of dysphonic patients and correlated them with individuals without voice alterations, in order to establish new therapeutic resources to rehabilitate the patients with dysphonia. Method: prospective study. A total of 43 individuals were analyzed (23 with dysphonia and 20 without voice alterations), of female gender, aged 18 to 40 years, without neurological, respiratory and rheumatic alterations. All patients were referred by the ENT Sector of Paulista Medical School (UNIFESP- EPM) after anamnesis, ENT examination and laryngoscopy, with diagnosis of functional or organofunctional dysphonia. The following parameters were investigated in this population: 1- Body posture in loco, 2- Photographic records, 3- Electromyographic examination, 4- Questionnaire on pain. Results: The results indicated no statistically significant difference with regard to the complaint, yet a larger number of individuals with dysphonia reported muscle tension and pain at the cervical region, where the larynx is located. Posture evaluation revealed that dysphonic individuals presented shoulder asymmetry, alterations in scapular positioning and rectification with forward displacement of the cervical region compared to the control group. The results of electromyographic analysis demonstrated increased activity of the suprahyoid muscle in prolonged emission, controlled emission and swallowing. The infrahyoid muscles exhibited altered electromyographic tracing during prolonged emission. Conclusion: It was concluded that there is correlation between individuals with dysphonia and posture alterations, based on the differences in clinical findings and electromyographic measurements.