Fisioter Mov. 2013 set/dez;26(4):página 813-20 doi: ISSN 0103-5150 Fisioter. Mov., Curitiba, v. 26, n. 4, p. página 813-820, set./dez. 2013 Licenciado sob uma Licença Creative Commons [T] Does usual practice of physical activity affect balance in elderly women?[I] Prática habitual de atividade física afeta o equilíbrio de idosas?[A]Eliane Regina Ferreira Sernache de Freitas [a] , Fernando Raphael Pinto Guedes Rogério [b] , Cárita Mayume Yamacita [c] , Mayara de Luca Vareschi [d] , Rubens Alexandre da Silva [e] [a] Physiotherapist, specialist in Exercise Physiology from Universidade Norte do Paraná (UNOPAR), Londrina, PR -Brazil, e-mail: fernandopintoguedes@hotmail.com [b] Physiotherapist, specialist in Manual and Postural Therapeutic Resources from the State University of Londrina (UEL), Londrina, PR -Brazil, e-mail: caritayamacita@gmail.com [c] Physiotherapist, specialist in Manual and Postural Therapeutic Resources from UEL, Londrina, PR -Brazil, e-mail: mayara.vareschi@unopar.br [d] Post-Ph.D in Health Sciences from the University of Montreal, professor at UNOPAR, Londrina, PR -Brazil, e-mail: rubensalex@hotmail.com [e] Ph.D in Health Sciences from the Federal University of São Paulo (UNIFESP), physiotherapist and Technical Supervisor at Irmandade da Santa Casa de Londrina (ISCAL), professor at UNOPAR, Londrina, PR -Brazil, e-mail: elianefe@sercomtel.com.br [R] Abstract Introduction: The systems responsible for maintaining postural control naturally went into decline with advancing age, something which may compromise the ability to keep posture within the stability limits, influencing on the balance of body structures and increasing the risk of falls. Objective: Check the impact of the usual practice of physical activity on stabilographic parameters, and the static and dynamic balance of physically independent elderly people. Materials and methods: This is a cross-sectional and descriptive study. The sample consisted of 77 women aged from 60 to 75 years, stratified into 5 groups according to the physical activity classified by means of the international Physical Activity Questionnaire (IPAQ). We used strength platform for stabilographic evaluation, one-foot standing test (static balance), and the time up and go test (dynamic balance). Results: We observed statistically significant differences in all stabilometric parameters analyzed, except in the oscillation speed in the X axis. On the other hand, the results regarding functional tests showed no significant difference among the groups, however, for the time up and go test we identified a tendency to good functional mobility with an increase in the usual practice of physical activity.

Relation of plantar pressure and range of movement of the lower limbs with the risk of falls in older women Relação da pressão plantar e amplitude de movimento de membros inferiores com o risco de quedas em idosasRelación entre la presión plantar y la amplitud de los movimientos de los miembros inferiores y el riesgo de caídas en adultos mayores

OBJETIVO: avaliar os parâmetros estabilométricos após a manobra de reposicionamento de Epley em indivíduos com Vertigem Posicional Paroxística Benigna (VPPB) previamente confirmada através da manobra de Dix-Hallpike. MÉTODOS: estudo experimental que incluiu pacientes que apresentaram VPPB com nistagmo de posicionamento à prova de Dix-Hallpike, avaliados no ano de 2008, no Ambulatório Multidisciplinar de Vertigem, e que foram submetidos à manobra de reposicionamento de Epley e avaliados quanto ao equilíbrio postural pelo exame de Estabilometria, antes e após a citada manobra. RESULTADOS: os 13 indivíduos do gênero feminino com idade variando de 15 a 78 anos com VPPB, previamente confirmados e selecionados para a pesquisa, apresentaram melhora estatisticamente significante em parâmetros estabilométricos verificados da primeira para a segunda avaliação, confirmando melhora do equilíbrio postural, após a manobra de Epley. CONCLUSÃO: nesta pesquisa a manobra de reposicionamento de Epley mostrou-se como um procedimento de intervenção importante para a melhora das respostas do equilíbrio postural em indivíduos com VPPB avaliados pela estabilometria.

RESUMOO equilíbrio corporal constitui uma importante capacidade para manutenção das atividades funcionais de idosos. A prática de exercícios físicos constitui um componente fundamental para a prevenção e reabilitação do equilíbrio. O objetivo deste estudo foi avaliar o equilíbrio corporal de idosas praticantes de exercícios físicos e idosas sedentárias asiladas da cidade de Londrina-PR. A amostra foi constituída de 36 idosas, com idades de 60 a 85 anos, divididas em dois grupos: fisicamente ativas (n=18) e asiladas sedentárias (n=18). A avaliação do equilíbrio estático na plataforma de força foi realizada em apoio bipodal durante 30 segundos com olhos abertos e fechados. Foram quantificados os deslocamentos do centro de pressão (CP) nas direções médio lateral (ML) e ântero-posterior (AP). Verificou-se oscilação do CP ML, 1,63±0,48 (ativas) e 2,50±0,59 (asiladas) com informação visual e 2,10±0,59 (ativas) e 2,75±1,16 (asiladas) sem informação visual e no CP AP (1,80±0,80) para as idosas ativas; 2,14±1,07 nas asiladas) com olhos abertos e 2,11±1,06 (ativas) e 2,13±0,94 (asiladas) com olhos fechados. Conclui-se que idosas praticantes de exercício físico possuem maior estabilidade postural quando comparados com as idosas asiladas. Palavras-chave:Envelhecimento. Controle postural. Estabilometria. ABSTRACTBody balance is an important capability for maintenance of functional activities of older people. The physical exercise is an essential component in the prevention and rehabilitation of balance. The aim of this study was to assess the body balance of elderly practicing of physical and sedentary institutionalized city of Londrina-PR. The sample consisted of 36 elderly, aged 60-85 years, divided into two groups: physically active (n=18) and sedentary institutionalized (n=18). Static balance was assessed in a force platform during 30 seconds in bipedal stance both, with eyes opened and closed. The variables analyzed were the center of pressure (COP) displacement in the medial lateral (ML) and anteroposterior (AP) direction. COP-ML displacement were 1.63 ± 0.48 (active) and 2.50 ± 0.59 (institutionalized) eyes opened and 2.10 ± 0.59 (active) and 2.75 ± 1.16 (institutionalized) eyes closed and the COP-AP displacement were 1.80 ± 0.80 for older active, 2.14 ± 1.07 (institutionalized) eyes opened and 2.11 ± 1.06 (active) and 2.13 ± 0.94 (institutionalized) eyes closed. We conclude that elderly practitioners of exercise have greater postural stability compared to institutionalized elderly sedentary.

| Objective:This study sought to analyze the effect of muscle fatigue induced by active isotonic resistance training at a moderate intensity by measuring the knee extension motion during the stabilometric response in a single-leg stance among healthy university students who perform resistance training on a regular basis. Method: Eleven healthy university students were subjected to a one-repetition maximum (1RM) test. In addition, stabilometric assessment was performed before and after the intervention and consisted of a muscle fatiguing protocol, in which knee extension was selected as the fatiguing task. The Shapiro-Wilk test was used to investigate the normality of the data, and the Wilcoxon test was used to compare the stabilometric parameters before and after induction of muscle fatigue, at a significance level of p≤0.05. Descriptive statistics were used in the analysis of the volunteers' age, height, body mass, and body mass index (BMI). Results: The sample population was 23.1±2.7 years of age, averaged 1.79.2±0.07 m in height and 75.6±8.0 Kg in weight, and had a BMI of 23.27±3.71 Kg.m -2 . The volunteers performed exercises 3.36±1.12 days/week and achieved a load of 124.54±22.07 Kg on 1RM and 74.72±13.24 Kg on 60% 1RM. The center of pressure (CoP) oscillation on the mediolateral plane before and after fatigue induction was 2.89±0.89 mm and 4.09±0.59 mm, respectively, while the corresponding values on the anteroposterior plane were 2.5±2.2 mm and 4.09±2.26 mm, respectively. The CoP oscillation amplitude on the anteroposterior and mediolateral planes exhibited a significant difference before and after fatigue induction (p=0.04 and p=0.05, respectively). Conclusions: The present study showed that muscle fatigue affects postural control, particularly with the mediolateral and anteroposterior CoP excursion.Keywords: rehabilitation; muscle fatigue; exercise; postural balance. HOW TO CITE THIS ARTICLEBruniera CAV, Rogério FRPG, Rodacki ALF. Stabilometric response during single-leg stance after lower limb muscle fatigue. Braz J Phys Ther. 2013 Sept-Oct; 17(5):464-469. http://dx

Introdução. O sangramento causado pelo cavernoma pode levar a déficits focais, afetando a articulação do tornozelo, dificultando a dorsiflexão, atividades funcionais decorrentes deste movimento e o desenvolvimento da marcha. A plataforma baropodométrica permite a visualização de variáveis oriundas do tornozelo. Objetivo. Verificar a efetividade da interface MESs-FESs associada a exercícios de reabilitação neurofuncional sobre a dorsiflexão de tornozelo e execução da marcha em um indivíduo após sangramento intraparenquimatoso por cavernoma. Método. Estudo de caso com uma participante avaliada por meio da (i) escala modificada de Ashworth, (ii) goniometria, (iii) eletromiografia de superfície (os dados foram normalizados) e (iv) baropodometria estática e dinâmica. A intervenção foi realizada em 6 sessões com duração de 30 minutos, onde a interface MESs-FESs era associada a exercícios de reabilitação. Resultados. O músculo tibial anterior não obteve aumento no seu valor eficaz (EMGRMS), porém, o músculo gastrocnêmio medial apresentou uma redução no EMGRMS de 55% durante a marcha, levando a um aumento de 30% da ADM, na baropodometria detectou-se maior simetria nas respostas plantares durante o ortostatismo, durante a marcha houve melhora no posicionamento do calcanhar, durante o contato inicial, e aplainamento do pé com subsequente maior tempo de apoio no membro acometido. Adicionalmente, foi observado melhora na mobilidade de tornozelo. Conclusão. A associação da interface MESs-FESs com exercícios de reabilitação mostrou ser efetiva como instrumento de auxílio no tratamento de sequelas de paresia do tornozelo. Sendo uma ferramenta viável e segura para inserção no ambiente clínico.

The aim of the study was identify the influence of gender and age of healthy adults on the foot structure and the plantar pressure during gait. Sample comprising 608 women and men participants. To identify the structure of the foot, anthropometric measurements of both the total and the truncated length of the foot, the width of the forefoot, and the heights of the back and navicular were taken. Peak pressure and plantar contact area in three foot-masks (forefoot, middle foot, and hindfoot) were considered markers of plantar pressure. The data were analyzed by two-way variance analysis. No significant influence of age on the foot structure dimensions was identified; however, women presented measures equivalent to the five significantly smaller anthropometric markers. As for the peak plantar pressure, both males and females showed statistically similar values, but significant differences were observed for age. As to the plantar contact area, while age did not have significant influence, men showed significantly higher values in the three foot-masks. The findings suggest that gender influences the foot structure and the plantar contact area, while age influences the peak of plantar pressure.

Introduction The measurement of plantar pressure is an important component in the evaluation of the locomotive system. However, the absence of norm-referenced measurement poses limitations to its use. Objective To verify the influence of gender on plantar pressure during gait in healthy adults and to propose norm-referenced measurement that may be used as a reference for monitoring. Methods The study included 353 healthy participants (158 females and 195 males), aged between 20 and 64 years, and with a normal foot posture. Using a pressure platform, the peak plantar pressure and pressure-time integrals were measured in three areas of the foot: forefoot, midfoot, and hindfoot. Results Both indicators of plantar pressure showed no significant differences between genders (p ≤ 0.05). Higher peak plantar pressure was found in the forefoot region, while a higher pressure-time integral was found in the hindfoot region. Percentile distribution values were made available for the data set of females and males. Conclusion The available norm-referenced measurement may be used to identify pathological gait parameters, monitor the efficacy of therapeutic interventions, and detect individuals in need of referral for a more sophisticated and detailed evaluation.