Patients with cerebral palsy account for great upper extremities deviationswhile walking. However, the number of studies assessing their upper bodygait kinematics are rare and no studies have been conducted interested inthe whole body kinematics during walking. In this study, we created awhole body index, the Body Profile Score made of modified existing kinematicindexes assessing the gait pattern of children with cerebral palsy. TheBody Profile Score (BPS) is an average of combination of the Gait ProfileScore (GPS), a modified Trunk Profile Score (TPS), a modified Arm PostureScore (APS) and a also new index called Head Profile Score (HPS), basedon a similar calculation. Dierent versions of the BPS were tested on threegroups: a control group, a CP group before botulinum toxin A treatmentand a CP group after botulinum toxin A treatment. The results showed apoor level of linear correlations between the dierent BPS versions and theGait Profile Score, indicating that lower body indexes such as the GPS orGait Deviation Index (GDI) and full body index such as the BPS do not renderthe same information. The BPS is the first index proposing a full bodykinematic analysis and aims at showing that such an analysis is needed ingait assessment of spastic children in order to have a realistic overview ofthe pathological walking condition.

Made available in DSpace on 2016-06-02T20:18:07Z (GMT). No. of bitstreams: 1 TeseRSP.pdf: 2033512 bytes, checksum: d5ddb9118edecd3afca2376359856f6d (MD5) Previous issue date: 2006-04-25 / Load handling activities impose great overloads on the musculoskeletal system, increasing the risk of injuries. The fact that these handling activities are considered risky had led to several studies regarding load lifting, lowering, pulling and pushing. The results obtained certainly allowed many findings about influence of different variables on risk factors of these activities. However, other studies are needed, especially about risks by load carrying activities, since the literature has not dealt extensively with this topic. Thus, studies have been carried out about load handling, leading to 4 scientific papers. Study one aimed at comparing two groups of workers, with and without musculoskeletal symptoms in the upper limbs when they performed simulated tasks of handling techniques as to trunk movements and load support. Movements analysis was quantified by a flexible electrogoniometer and contact between load and trunk, by load cells. Nine asymptomatic and 10 symptomatic industrial workers were evaluated. An ANOVA was performed to compare results between symptomatic and asymptomatic workers. Most of the symptomatic workers supported the load on their trunk, whilst most of the asymptomatic did not. Higher values of lumbar flexion occurred for the symptomatic workers (p<0,05). The objective of the second study was ti describe trunk movements in sedentary subjects, and in workers with and without musculoskeletal symptoms, when carrying loads in simulated tasks. The 38 subjects who participated in this study were divided into 4 groups, consisting of 9 male students, 10 female students, 10 female symptomatic industrial workers and 9 asymptomatic industrial workers. The trunk movements of all subjects were recorded by biaxial back electrogoniometer when carrying loads between surfaces of different heights. An analysis of variance for repeated measures were performed, which was followed by the Duncan post hoc test for comparison of anthropometrical data between subjects, amplitude of movement, and time spent in each movement per group and per experimental condition. The height of the surfaces to which the loads were carried to or from, significantly influenced the trunk positions during handling (p<0,01), as if subjects were anticipating the target position whilst handling. Also more time was spent in flexion (p<0,01) than in extension. These aspects increase the risks of possible injury in such activities. The objective of the third study was to describe the kinds of grip used during handling activities of 5Kgf and 10 Kgf loads between surfaces of different height and to quantify flexion/extension movements and wrist radial and ulnar deviations quantified by electrogoniometry. Ten male volunteers participated in this study handled a box between surfaces of different heights. The activities was performed to evaluate significant differences between the anthropometry of volunteers´ hands and between movements used for load handling and different heights. The results showed that the surface heights to which the objects were handled significantly influenced (p=0,000) joint amplitudes, nevertheless there wasn t any difference in the movements for different load masses handled (p=0,43). Time over what is considered advisable was spent in radial deviation when handling involved high surfaces. The fourth study aimed at evaluating the anterior-posterior movements of the trunk and the time spent in task performance by experienced and inexperienced subjects during load handling activities to different target surfaces. The 36 subjects who participated in this study were healthy males, divided into groups of 16 and 20, experienced and inexperience respectively, in the performance of load handling activities. The activities consisted of carrying the 7Kg and 15Kg boxes from a surface at a fixed height to another at a variable height. Lumbar thoracic movements were quantified by a flexible electrogoniometer. Significant differences were found in the time spent to perform the handling between the groups (p<0,008) and between the loads (p<0,000). However, there was no significant difference in the trunk movemets between the groups (p>0,005) and the loads (p>0,005). Surfaces heights to which the box was transported significantly influenced trunks movements (p<0,000). / As atividades de manuseio de carga geram grandes sobrecargas ao sistema músculoesquelético, aumentando com isso os riscos de lesões. O fato dessas atividades de manuseio serem consideradas de risco fez com que muitos estudos fossem realizados considerando situações de levantamento, abaixamento, puxar e empurrar cargas. Os resultados obtidos certamente permitiram muitas descobertas sobre as diferentes variáveis envolvidas e os fatores de risco dessas atividades. Contudo, são necessidade outros estudos principalmente sobre os riscos gerados por atividades de carregamento de carga, já que a literatura cientifica aborda muito pouco essa temática. Assim, foram então realizados estudos sobre atividade de carregamento de carga que geraram 4 (quatro) artigos científicos. O objetivo do Estudo I foi comparar dois grupos de trabalhadores com e sem sintomas músculo-esqueléticos em membros superiores quando realizaram tarefas simuladas de manuseio, quanto aos movimentos do tronco e suporte da carga. A análise do movimento foi realizada por meio de um eletrogoniômetro flexível, o contato entre a carga e o tronco foi mensurado por meio de células de carga. Foram avaliados 9 trabalhadores assintomáticos e 10 sintomáticos. Para comparar os resultados entre sintomáticos e assintomáticos utilizou-se uma ANOVA. A maioria dos trabalhadores sintomáticos apoiou a carga no tronco enquanto que a maioria dos assintomáticos não. A amplitude de movimento de flexão lombar que ocorreram no grupo de trabalhadores sintomáticos foram bem maiores do que no grupo de assintomáticos (p<0,05). O objetivo do segundo estudo foi descrever os movimentos do tronco em indivíduos sedentários e em trabalhadores com e sem sintomas músculo-esqueléticos. Participaram do estudo 38 indivíduos sendo divididos em 4 grupos, 9 homens estudantes, 10 mulheres estudantes, 10 trabalhadoras sintomáticas e 9 trabalhadoras assintomáticas. Os movimentos do tronco foram registrados por um eletrogoniômetro biaxial de tronco durante o carregamento de carga para diferentes alturas de superfícies. Uma análise de variância ANOVA para medidas repetidas foi aplicada. Os resultados mostraram que a altura das superfícies para a qual a carga seria levada influenciou significativamente os movimentos do tronco (p<0,01) e que mais tempo foi gasto em movimentos de flexão quando comparados à extensão do tronco (p<0,01). O objetivo do terceiro estudo foi descrever os tipos de preensão empregados durante atividades de manuseio de cargas de 5 e 10Kgf entre superfícies de alturas diferentes e, quantificar os movimentos de flexão/extensão, desvio radial e ulnar do punho registrados por meio da eletrogoniômetria. Participaram 10 voluntários do sexo masculino que manusearam uma caixa entre superfícies de diferentes alturas. A atividade foi filmada para identificar os tipos de preensão empregados durante a tarefa. Uma análise de univariância foi utilizada para avaliar diferenças significativas entre a antropometria das mãos dos voluntários, e entre os movimentos utilizados para o manuseio de cargas para diferentes alturas. Os resultados mostraram que as alturas das superfícies para as quais as cargas eram manuseadas influenciaram significativamente (p=0,000) as amplitudes articulares, contudo não houve diferença significativa nos movimentos para as diferentes massas das cargas manuseadas (p=0,43). O gasto tempo acima das faixas de amplitude consideradas recomendáveis foi expressivo para os movimentos de desvio radial quando os manuseios envolviam superfícies altas. O quarto estudo objetivou avaliar os movimentos antero-posteriores do tronco e o tempo gasto na realização da tarefa, por indivíduos experientes e inexperientes, durante atividade de carregamento de cargas para diferentes superfícies alvo. Participaram do estudo 36 homens saudáveis, sendo 16 experientes e 20 inexperientes na realização da atividade de manuseio de carga. A atividade consistiu no transporte de caixa com massa de 7 e 15kg, partindo de uma superfície com altura fixa e depositavam a caixa em uma outra superfície de altura variável. Os movimentos da coluna tóraco-lombar foram registrados com um eletrogoniômetro flexível. Foram encontradas diferenças significativas no tempo gasto para realizar os manuseios entre grupos (p<0,008) e entre cargas (p<0,000). Contudo não houve diferença significativa (p>0,05). As alturas das superfícies para as quais a caixa era deslocada influenciaram significativamente os movimentos do tronco (p<0,000).