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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
421

Analyse tridimensionnelle de la posture et de la cinématique rachidienne / Postural and kinematic tridimensional analysis of the spine

Blondel, Benjamin 15 December 2014 (has links)
L'analyse de la posture constitue un élément fondamental dans l'évaluation diagnostique et thérapeutique des patients atteints de déformations rachidiennes. Classiquement basée en pratique courante sur des radiographies du rachis en totalité, de nombreux paramètres posturaux ont été décrits et corrélés à la qualité de vie des patients. Toutefois, l'analyse radiographique conventionnelle ne permet pas systématiquement d'appréhender la posture véritable d'un individu. Une approche biomécanique de la posture en laboratoire d'analyse du mouvement permet donc de s'affranchir de ces contraintes et de caractériser la posture à l'aide de nouveaux paramètres. Un protocole spécifique biomécanique d'analyse de la posture, utilisant des plateformes de force et un système optoélectronique, a été développé afin de caractériser la posture libre d'un individu. D'autre part, ce protocole d'analyse peut ensuite être adapté à la pratique clinique quotidienne en couplant les données issues de la radiographie à celles d'une plateforme de pression. L'analyse d'une cohorte de volontaires sains a ainsi été réalisée, confirmant la faisabilité technique du calcul des moments nets inter segmentaires à l'aide de radiographies et d'une plateforme de pression. Les résultats de ce travail mettent en évidence la faisabilité et la fiabilité du protocole de mesure des moments inter-segmentaires. Ces résultats ouvrent des perspectives en pratique clinique courante avec la possibilité de réaliser cette analyse en pré et postopératoire a des fins diagnostics mais également pour évaluerl'influence du traitement chirurgical sur la modification des contraintes exercées sur le rachis. / Postural analysis is of primary importance for clinical and therapeutic evaluation of spinal deformity patients. This evaluation is currently based on full-spine radiographs and various parameters have been described and correlated with health related quality of life scores. However, this radiographic analysis is not applicable to every patient and can be sometimes misleading for physicians. A biomechanical postural approach using gait analysis is therefore necessary in order to avoid limits from the radiographic analysis. It provides new parameters for postural evaluation. A dedicated biomechanical "free-posture" protocol has been developed using force plates and gait analysis markers. Results from this approach revealed the reliability of the inter-segmental moment's measurements. Evolution of postural parameters during growth according to age was also described using a pediatric cohort. Concurrently, this biomechanical protocol can also be adapted to daily clinical practice, by the combination of a pressure platform and full-spine x-rays. Reliability of this combination was reported on a cohort of volunteers on whom spinal constraints were measured. These results are a source for potential new methods of postural outcomes evaluation in daily practice as they can be calculated during preoperative and postoperative courses.
422

Exploring the effects of dietary restriction and macronutrient composition on life-history traits in a non-model vertebrate system

Moatt, Joshua Philip January 2018 (has links)
Dietary restriction (DR), is a reduction in food intake, either through overall calorie or specific macronutrient intake, while avoiding malnutrition. DR has been consistently shown to increase longevity and protect against age related diseases. Although originally thought to be the result of a reduction in caloric intake, recent evidence suggests that the ratio of macronutrients, particularly that of protein : non-protein energy, also plays a role. The broad range of species in which DR is known to be effective, suggests an evolutionary conserved mechanism. However, the suggestion of a strong model species bias and a potential sex bias have led some to question the ubiquity of responses to DR. Here, I address the following questions: (i) How consistent is the effect of DR on reproduction? (ii) How does varying macronutrient intake effect both growth and body composition in three-spine sticklebacks (Gasterosteus aculeatus)? (iii) What is the effect of dietary macronutrient intake on lifespan and reproduction in the three-spine stickleback? and (iv) How does changing macronutrient intake impact fitness related traits, such as condition and performance in three-spine sticklebacks? Through use of a systematic review and meta-analysis, I show that the effect of DR on reproduction is evolutionarily conserved, though the effect is stronger in model species. However, when accounting for all significant moderators there is no evidence of the suggested sex differences in the effect of DR. I show that body composition is predicted by dietary lipid intake, with sticklebacks targeting a lower ratio of protein : fat within the body, potentially via metabolism and excretion of protein. These results hint at a link between conversion and excretion of protein and survival costs associated with high protein diets. I show that mortality risk is reduced at balanced protein : lipid intakes in males and generally at low protein : lipid intakes for females. However, the effect in females is not consistent throughout life. I further show that reproduction is maximised on high protein : lipid intakes for both sexes. These results suggest a macronutrient mediated trade-off between lifespan and reproduction in male three-spine sticklebacks. Finally I show a positive effect of lipid intake on male condition (a possible indicator of overall health) hinting at a relationship between lipid intake, adiposity, health and lifespan in male three-spine sticklebacks.
423

Modelo biomecânico tridimensional para análise das forças internas atuantes na coluna cervical superior e inferior durante o ciclismo

Pasini, Maicon January 2009 (has links)
Elevados índices de dor cervical e lombar têm sido reportados em ciclistas. Fatores como a postura adotada na bicicleta, a ativação dos músculos extensores da coluna e a ação de cargas mecânicas nas estruturas da coluna tem sido apontados como possíveis causas da dor. Embora relatados e aparentemente aceitos, poucos estudos objetivaram investigar estes fatores. Em adição, a dor crônica não específica é frequentemente diagnosticada em ciclistas, pois poucas evidências de anormalidade são observadas quando realizados exames radiológicos clínicos. O emprego de métodos biomecânicos de investigação, como a estimativa da magnitude da força muscular dos extensores da coluna e da força articular em diferentes níveis da coluna poderia contribuir para avaliação do risco de lesão e dor em decorrência do ciclismo, além de auxiliar na criação de estratégias de prevenção e programas de reabilitação. Assim, este estudo teve como objetivo quantificar e comparar as forças internas atuantes na coluna cervical durante o ciclismo em diferentes posturas, por meio do desenvolvimento e aplicação de um modelo biomecânico tridimensional in vivo. O modelo biomecânico proposto foi composto por dois segmentos rígidos (coluna cervical superior e inferior) conectados. O segmento coluna cervical superior compreende a cabeça, C1 e C2. O segmento coluna cervical inferior compreende as vértebras cervicais de C3 a C7. No segmento coluna cervical superior são considerados dois vetores de força muscular: FM1 (rectus capitis posterior major, rectus capitis posterior minor, obliquus capitis superior e obliquus capitis inferior) e FM2 (semispinalis capitis e splenius capitis). Já no segmento coluna cervical inferior estão inclusos os vetores FM3 (semispinalis cervicis) e FM4 (splenius cervicis). A resolução das equações de movimento de Newton-Euler é realizada por meio da solução inversa. Os parâmetros cinemáticos foram obtidos utilizando imagens externas da cabeça e coluna cervical, adquiridas por meio de quatro câmeras de vídeo digital com frequencia de amostragem de 25 Hz. Para estimar a localização dos centros de rotação (C2-3 e C6-7) foram realizados exames radiológicos convencionais estáticos. Os parâmetros de massa e centro de massa foram retirados de tabelas antropométricas da literatura. Participaram do estudo 12 ciclistas com pelo menos dois anos de experiência competitiva cada. O estudo foi aprovado pelo Comitê de Ética em Pesquisa da Universidade Federal do Rio Grande do Sul e os sujeitos assinaram um termo de consentimento livre e esclarecido. Cada participante foi avaliado utilizando sua própria bicicleta acoplada a um ciclossimulador magnético, em duas etapas realizadas no mesmo dia. Inicialmente foi mensurada a massa corporal total do individuo e em seguida identificados e marcados 14 pontos anatômicos de interesse com uma caneta dermatográfica. Durante as avaliações foram fixos marcadores revestidos com papel reflexivo e contendo chumbo no interior em todos os pontos anatômicos de interesse. Na Etapa I os sujeitos pedalaram durante 2 minutos em cada postura (ereta, descanso, intermediária, ataque e cotovelos flexionados), sendo coletados dados cinemáticos durante os últimos 30 segundos de cada uma. Na Etapa II foram realizados exames radiológicos estáticos em cada uma das 5 posturas analisadas (ereta, descanso, intermediária, ataque e cotovelos flexionados) e em flexão e extensão máximas da coluna cervical. Os resultados indicam que as forças internas atuantes nas estruturas da coluna cervical apresentaram maiores magnitudes nas posturas que envolvem a prática do ciclismo (descanso, intermediária, ataque e cotovelos flexionados), quando comparadas a postura de referência (ereta). Observando somente as posturas que envolvem o ciclismo, as forças internas aumentaram gradativamente a medida que os ciclistas transferiram o apoio de suas mãos da região superior para a região inferior do guidão, adotando as posturas descanso, intermediária e ataque, respectivamente. Entretanto, as maiores magnitudes das forças internas foram observadas quando os ciclistas efetuaram o apoio das mãos envolvendo os manetes e flexionaram a articulação do cotovelo (postura cotovelos flexionados). Proporcionalmente os maiores aumentos das forças internas ocorreram na coluna cervical superior, porém as maiores magnitudes das forças internas foram alcançadas na coluna cervical inferior. O processo de avaliação demonstrou que o modelo biomecânico tridimensional da coluna cervical proposto foi considerado capaz de representar de maneira confiável o sistema de interesse. Os resultados encontrados são coerentes, sendo o modelo um instrumento adequado para estimar as forças internas atuantes na coluna cervical durante o ciclismo em diferentes posturas. / High index of cervical and lumbar pain had been registered in cyclists. Factors as a posture adopted on bicycle, the activity of spine extensor muscles and the action of mechanical load in the spine structures had been put like possible causes of pain. Although related and apparently accepted, few studies investigate these factors. In addition, the non-specific chronic pain is frequently diagnosed in cyclists, because few evidences of abnormalities are investigated when clinic radiologics exams are done. The use of biomechanical methods of investigation, like the estimate of muscular force magnitude of extensors of spine and of joint force in different levels of spine can be contributed to evaluation of injury risk and pain caused by cycling, beyond the assist in strategies of prevention and rehabilitation programs. Therefore, this study had like objective to quantify and compare the active internal forces in the cervical spine during cycling in different postures, through development and application of three dimensional in vivo biomechanical model. The biomechanical model suggested was compound by two rigid segments (upper and lower cervical spine) connected. The upper cervical spine segment include head, C1 and C2. The lower cervical spine segment include cervical vertebraes of C3 to C7. In the upper cervical spine segment are considered two vectors of muscular force: FM1 (rectus capitis posterior major, rectus capitis posterior minor, obliquus capitis superior e obliquus capitis inferior) and FM2 (semispinalis capitis e splenius capitis). In the lower cervical spine segment are included the vectors FM3 (semispinalis cervicis) and FM4 (splenius cervicis). The resolution of movement equation of Newton-Euler is done through inverse dynamics. The kinematic parameters were obtained using external images of head and cervical spine, acquired by four digital video cameras with sampling frequency of 25 Hz. To estimate the location of rotation centers (C2-3 and C6-7) statics conventional radiologic exams were done. The parameters of mass and center of mass were removed of anthropometric tables of literature. 12 cyclists with at least two years of competitive experience each one participated of the study. The study was approved by Ethics Committee in Researches of Federal University of Rio Grande do Sul and the subjects signed a free and clear consent term. Each participant was assessed using your bicycle attached in a magnetic cycle simulator, in two stages done in the same day. Initially the total body mass of subjects was measured and then 14 anatomic points of interest were identified and marked with a dermatography pen. During the evaluation markers encased with reflective paper and containing lead inside of these markers were fixed in all anatomic points of interest. In the stage I the subjects rode a bicycle during 2 minutes in each posture (upright neutral, rest, intermediate, attack and flexed elbows). The kinematic data were collected during the last 30 seconds of each one. In the stage II static radiologic exams were done in each of 5 analyzed postures (upright neutral, rest, intermediate, attack and flexed elbows) and in maxim flexion and extension of cervical spine. The results indicate that the internal forces active in the structures of cervical spine presented more magnitudes in the postures that involve the cycling practice (rest, intermediate, attack and flexed elbows), when compared to reference posture (upright neutral). Observing just the postures that involve the cycling, the internal forces gradually increased as cyclists transferred the your hands from upper to lower region of handlebar, adopting the rest, intermediate and attack postures, respectively. However, the greater magnitude of internal forces were observed when the cyclists hands involving the brake levers and flexed the elbow joints (flexed elbows posture). Proportionally the greatest increase of internal forces occurred in the upper cervical spine, however the greatest magnitudes of internal forces were reached in the lower cervical spine. The evaluation process demonstrated that the three dimensional biomechanical model of cervical spine was considered able to represent of reliable way the interest system. The results found are coherent, the model is an adequate instrument to estimate the internal forces active in the cervical spine during cycling in different postures.
424

Automated radiological analysis of spinal MRI

Lootus, Meelis January 2015 (has links)
This thesis addresses the problem of analysing clinical MRI using modern computer vision methods for a variety of clinical and research-related tasks. We use automated machine learning algorithms to develop a spinal MRI analysis framework for a number of tasks such as vertebrae detection, labelling; disc and vertebrae segmentation, and radiological grading, and we validate the framework on a large, heterogeneous dataset of 300 symptomatic back pain patients from multiple clinical sites and scanners. Our framework has a number of back pain research and other spine-related clinical applications and could hopefully find application in a clinical workflow in the future. Our framework has five steps -- detection, labelling, segmentation, support regions and features, and machine learning for radiological measurements. The framework works in full 3D and has currently been implemented on sagittal T2 slices. We use Deformable Part Models along with a chain model to detect and label vertebrae, and a powerful graph cuts based method for vertebrae and disc segmentation. The labelled detections and segmentations are used to place support regions for feature extraction, which are mapped into a number of radiological measurements -- namely Pfirrmann grade, disc space narrowing, and herniation/bulge. The radiological ground truth was provided by a clinical radiologist with 25 years experience. We demonstrate a high performance in the measurement in each. The measurements are performed using support vector machines and support vector regressors learned on training data. We next investigate the problem of what is the best method of obtaining support regions. We first used pixel intensity features to predict the Pfirrmann grade, narrowing and bulge/herniation, with vertebrae segmentation to localise their support regions. Since segmentation of spine images, especially intervertebral discs is an unsolved problem and algorithms are prone to failure, we then ask the question, to segment or not to segment. To answer the question, we compare results on Pfirrmann grade prediction with three different points on the no segmentation to full disc segmentation involving no segmentation, vertebrae segmentation, or disc segmentation and find that vertebrae segmentation suffices. We finally show preliminary results in distinguishing between different radiological conditions related to the posterior side of the disc more finely than before in literature, taking information from both sagittal and axial slices to attempt to distinguish between herniated and bulged discs.
425

Kinematika cervikothorakálního regionu páteře v kontextu celkového držení těla / Kinematic of cervical thoracic spine in the context of whole body posture

Vláčilová, Ivana January 2015 (has links)
Title: Kinematic of cervical thoracic spine in the context of whole body posture Problematics: This work describes the kinematics of upper thoracic spine during specific movement of the shoulder girdle. The kinematic changes are evaluated with the relationship of the whole body posture. Aim: To develop the objective evaluation of the posture and the amount of the segmental spinal movement of cervical thoracic spine. To describe the relationship between the specific movement of arm - adduction and external humeral rotation - and the posture using 3D kinematic analysis. To objectify this tested movement as a diagnostic tool or a therapy for forward head posture. Methods: The theoretical part of this work summarizes the current knowledge of poor posture and there is defined the upright posture. The experimental part describes the measurement of the movement of shoulder girdle and its response to the axial system using 3D kinematic analysis. Result: The results of kinematic 3D motion analysis show that the external humeral rotation with adduction of the shoulder leads to the upright posture if there is the horizontal position of the thorax and pelvis. The posture was divided due to the physiological or pathological response with this simple movement. Conclusion: A new model for evaluation of the...
426

Pedagogika jógy vzhledem ke zdraví populace se zaměřením na rotační polohy a jejich přínos pro fyzioterapii. / Pedagogy of yoga with regard to population health: a focus on rotational positions and their contribution to physiotherapy.

Hloušková, Pavlína January 2018 (has links)
Title: Pedagogy of yoga with regard to population health: a focus on rotational positions and their contribution to physiotherapy. Objectives: The aim of the thesis is to briefly summarize the general knowledge of the positive influence of yoga on the human musculoskeletal apparatus, and then to focus on the description of the rotation movements, consdiering both terms of yoga practice and the anatomical- kinesiological (physiotherapeutic) point of view. Three selected yoga positions will be examined; Bharadvádžásana, Maríčjásana and Parivrtta trikonasana, based on literature dealing with the practice of yoga asanas. In the practical section, the discrepancies between theory and practice will be evaluated, as well as the quality of yoga provided during the lessons in relation to population health. These discrepancies will be assessed from the perspective of a physiotherapist. Methods: It is a descriptive theoretical-empirical type of research. The methods used to collect data were - search research, observation, interview. Results: Discrepancies between the theoretical description in the literature and practice have been present. It was also confirmed that the rotational positions were part of all the attended yoga lessons. The assumption that the lecturers know the health of their trainees has not...
427

Vliv manuální terapie v oblasti krční páteře na rovnovážné funkce hodnocené pomocí CDP u houslistů / The effect of manual therapy of the cervical spine on standing balance of violinists measured by CDP

Pitřincová, Marie January 2018 (has links)
Title: The effect of manual therapyof the cervical spine on standingbalance of violinists measured by CDP Objectives: The intention of this thesis is to describe most frequent functional changes of musculoskeletal apparatus of violinists. Secondly, to track and react to these changes with appropriate manual there of the cervical spine. Thirdly, to find out if this therapy has an effect maintaining postural stability by testing on a posturograph using the SOT protocol. Methods: This is a pilot study that uses subjective and objective examinations. Subjectively, the functional changes of the musculoskeletal apparatus were examined and then their frequency within the proband group was evaluated (n = 10, 2 men and 8 women). Within the objective examination, 15 parameters of postural stability were monitored under certain conditions. Using the Wilcoxon Pair Test, situations before and after manual therapy of the cervical spine were compared. The statistical significance level was set to α = 0.05 for this test. Results: The study has shown that violinists have some functional changes in the musculoskeletal apparatus in common. Their most frequent blockade is AO joint (9 out of 10 violins), the most common hypertonus can be found in flexors of the forearm of the left hand (9 out of10) andthetrapezius and...
428

Pedagogika jógy vzhledem ke zdraví populace se zaměřením na obrácené polohy a jejich přínos pro fyzioterapii. / Pedagogy of yoga due to population health targeted to inverse positions and their effectivness to physiotherapy

Hynková, Zdeňka January 2018 (has links)
Title: Pedagogy of yoga due to population health targeted to inverse positions and their effectivness to physiotherapy Objectives: In the theoretical part of this thesis the aim is to research the pedagogy of selected inverted positions (Šíršásana, Sarvángásana, Prasárita Pádottánásana) and to subsequently evaluate their contribution to physiotherapy. In the practical part of the the thesis the aim is to determine the level of pedagogy of applied yoga in selected fitness centers of Prague and Hradec Králové in relation to public health. Methods: The thesis has a descriptive theoretical and empirical character. The theoretical part of the thesis is a form of research. The practical part of the thesis is conducted in the form of a blind experiment when an instructor of a public lesson is observed and then an interview is conducted. Results: Significant discrepancies in the pedagogy of selected inverted positions were found among the authors of yoga publications, but also between literature and yoga practice in public yoga lessons. Inverse positions are not part of each open lesson. Selected inverse positions were trained during only 13 lessons of the 20 lessons that were involved to the research. Only two of twenty lecturers had health education both of them did the right yoga pedagogy but the...
429

Evaluation of fin ray and fin spine chemistry as indicators of environmental history for five fish species

Smith, Kurt Thomas 01 December 2010 (has links)
Knowledge of environmental history is important for the management and conservation of fish populations. Multiple methods to tag or mark fish have been developed (e.g., radio transmitters, coded wire tags, PIT tags, genetic markers), however, each of these methods has limitations. Naturally occurring and artificial chemical markers in otoliths have recently been used to determine natal origins and environmental history of fishes in both marine and freshwater environments and are not subject to the shortcomings of conventional tagging methods. However, few studies have evaluated the application of fish fin rays as a non-lethal alternative to fish otoliths as a recorder of individual fish environmental history. Therefore, I evaluated the application of artificial and naturally occurring chemical markers in fish fin rays as tracers of individual environmental histories. Specifically, I sought to determine 1) if age-0 lake sturgeon pectoral fin rays could be marked by immersion in strontium carbonate (SrCO3) enriched with the stable isotope 86Sr (86SrCO3), 2) whether natural differences in otolith and fin spine chemistry are present in catfish species collected from the Mississippi River basin, and 3) whether natural differences in fin ray chemistry are present in smallmouth bass from different rivers and streams in northern Illinois. Results from the first objective indicated that age-0 lake sturgeon were marked with 83% success when reared in water enriched with 100 µg/L of 86SrCO3, compared to control fish, and mark retention was maintained for at least 120 d following the labeling period. Results of the second objective indicated that both catfish otolith Sr:Ca, δ18O, and δ13C and fin spine Sr:Ca differed among sites, reflecting geographic differences in water chemistry at source locations. Both structures classified fish to their environment of capture with a high degree of accuracy, except in the Middle and Lower Mississippi Rivers where many recent immigrants appeared to be present. Similarly, smallmouth bass fin ray core Sr:Ca differed among sites, reflecting previously documented differences in water chemistry among streams and rivers in northern Illinois. Classification accuracy of smallmouth bass to their environment of capture based on fin ray Sr:Ca was variable, as some rivers had similar water chemistry signatures. The use of artificial chemical marks in fin rays will be useful when marking small fish that may not respond well to physical tags, when non-lethal recovery is desirable, and to distinguish between multiple batches of stocked fish (i.e. to evaluate factors such as stocking location and timing, fish size, and when fish may become interspersed into the existing population). Natural chemical signatures in pectoral fin rays or fin spines may provide a non-lethal alternative to otoliths for gathering information on environmental history (e.g. stock mixing, recruitment sources) of smallmouth bass and catfishes, consistent with recent demonstrations of this technique's effectiveness in other fish species. Ultimately, the use of artificial and naturally occurring chemical marks in fish fin rays provides a non-lethal alternative method to evaluate the environmental history of all life stages of fish
430

Validação de um sistema de escaneamento 3d para avaliação das curvaturas da coluna vertebral de crianças em diferentes perfis nutricionais

Sedrez, Juliana Adami January 2013 (has links)
A presente dissertação de mestrado teve como objetivo verificar a validade concorrente, a repetibilidade, a reprodutibilidade interavaliador, a sensibilidade e a especificidade do sistema Vert 3D na avaliação das curvaturas frontais e sagitais de crianças com diferentes perfis nutricionais. Inicialmente foram realizadas duas revisões sistemáticas da literatura com o objetivo de investigar a existência de evidências científicas sobre os instrumentos de avaliação não invasiva da escoliose, cifose torácica e lordose lombar. A partir dessas revisões sistemáticas foi possível observar que, em geral, os instrumentos apresentaram condições satisfatórias para a avaliação não invasiva das curvaturas da coluna vertebral. Além disso, parece haver consenso na literatura sobre a aplicabilidade dos instrumentos não invasivos, os quais são indicados para o acompanhamento clínico, com o objetivo de reduzir a exposição frequente aos Raios-X sem, no entanto, possibilitar a substituição da radiografia. No entanto, ainda há carência na literatura de estudos com forte evidência científica no que tange a validação dos instrumentos não invasivos de avaliação da coluna vertebral, e por esse motivo, desenvolveu-se um estudo original com a finalidade de investigar os aspectos de validação do sistema Vert 3D. Foram avaliadas 115 crianças, as quais foram submetidas à radiografia panorâmica da coluna vertebral sagital e frontal, além de cinco avaliações com o sistema Vert 3D, por três avaliadores treinados. Os resultados demonstraram que o sistema Vert 3D: (1) apresentou excelentes níveis de repetibilidade e reprodutibilidade interavaliador para os ângulos de cifose torácica e lordose lombar; (2) apresentou fraca correlação com o ângulo de Cobb para cifose torácica e correlação moderada para lordose lombar; (3) para avaliação do plano frontal, o sistema Vert 3D apresentou nível moderado de repetibilidade para flechas à esquerda e nível fraco a moderado para flechas à direita; (4) a reprodutibilidade interavaliador apresentou nível moderado para as flechas escolióticas à direita e à esquerda; (5) não houve correlação significativa entre as flechas à direita e os ângulos Cobb para a direita e houve correlação fraca entre as flechas à esquerda e os ângulos Cobb a esquerda; (6) a repetibilidade e reprodutibilidade interavaliador manteve bons níveis de correlação independente do perfil nutricional avaliado, nos dois planos investigados. Conclui-se que o sistema Vert 3D apresentou adequados níveis de repetibilidade e reprodutibilidade interavaliador para a avaliação de crianças de todos os perfis nutricionais, podendo dessa forma, ser utilizado no acompanhamento clínico das curvaturas da coluna vertebral nos planos frontal e sagital. No entanto, até o presente momento não é possível utilizar esse sistema para o diagnóstico de alterações posturais, nem mesmo para estimar o ângulo de Cobb, já que não foram encontradas adequadas correlações e concordâncias com os exames radiográficos. Ainda, o sistema Vert 3D não tem a pretensão de substituir o exame radiológico, mas pode ser utilizado como uma importante ferramenta no fornecimento de informações adicionais à cerca do posicionamento da superfície do dorso, possibilitando ampliar o conhecimento da avaliação postural, visando um planejamento adequado de intervenções pelos profissionais da saúde. Além disso, com a utilização desse sistema, pode-se reduzir a exposição frequente aos Raios-X. / This master degree dissertation had the objctive of verify the concurrent validity, repeatability, reproducibility interrater, the sensitivity and the specificity of the Vert 3D system in the evaluation of frontal and sagittal curvatures in children with different nutritional profiles. Initially it was performed two systematic reviews of the literature with the purpose of investigate the existence of scientific evidence regarding the instruments of noninvasive evaluation of scoliosis, thoracic kyphosis and lumbar lordosis. Based on these systematic reviews it was possible to observe that, in general, the instruments showed satisfactory conditions for noninvasive evaluation of spinal curvatures. Furthermore, there seems to be a consensus in the literature about the applicability of noninvasive instruments, which are indicated for clinical monitoring, in order to reduce the frequent exposure to X-rays without, however, allowing the replacement of radiography. However, there is still a lack of studies in literature with a strong scientific evidence Regarding the validation of noninvasive evaluation instruments of the spine, and for this reason, it was developed an original study in order to investigate aspects of the validation of the Vert 3D system. It was evaluated 115 children, who underwent panoramic radiography of the spine in sagittal and frontal planes, and five assessments with the Vert 3D system, by three trained raters. The results showed that the the Vert 3D system: (1) showed excellent levels of repeatability and reproducibility Interrater for angles of thoracic kyphosis and lumbar lordosis; (2) showed a weak correlation with the Cobb angle for thoracic kyphosis and moderate correlation for lumbar lordosis; (3) to evaluate the frontal plane the Vert 3D system presented a moderate level of repeatability for arrows to the left and weak to moderate for arrows to the right; (4) the interrater reproducibility showed a moderate level to the scoliosis arrows to the right and left; (5) there was no significant correlation between the arrows to the right and Cobb angles to the right and there was a weak correlation between the arrows to the left and the left Cobb angles; (6) the repeatability and the interrater reproducibility maintained good levels of correlation independent of nutritional status evaluated in the two plans investigated. It is concluded that the Vert 3D system presented adequate levels of repeatability and Interrater reproducibility for the evaluation of children of all nutrient profiles, and can this way it can be used in the clinical monitoring of spinal curvatures in the sagittal and frontal planes. However, until this moment it is not possible to use this system for the diagnosis of postural alterations, not even to estimate the Cobb angle, since were not found appropriate correlations and concordances with radiographs. Still , the Vert 3D system does not intend to replace the radiological examination, but can be used as an important tool in providing information about the positioning of the back surface, making it possible to enhance the knowledge about postural evaluation, seeking a proper planning of interventions by health care professionals. Furthermore, by using this system one can reduce frequent exposure to X-rays.

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