RESUMO Introdução: O limite de estabilidade caracteriza-se pelo ângulo máximo de inclinação que um indivíduo pode alcançar e pela maior variabilidade em condições extremas; trata-se de uma estratégia arrojada e/ou perigosa do controle motor. Objetivos: Avaliar se as medidas antropométricas e a composição corporal interferem nos limites de estabilidade e nas descargas de peso em diferentes velocidades em adultos. Métodos: Foram analisados 87 indivíduos de ambos os sexos, entre 20 a 40 anos de idade, por meio de avaliação antropométrica e composição corporal. Para as avaliações de equilíbrio foram usados uma plataforma de força, testes de limite de estabilidade (LE) e troca rítmica de peso (TRP). Resultados: No teste de LE, o sexo feminino correlacionou-se negativamente com o tamanho do pé e o tempo de reação e positivamente com a excursão máxima. Na TRP, o grupo feminino apresentou correlação negativa com estatura e comprimento do membro superior (CMS) com controle de direção médio-lateral. O grupo masculino apresentou correlação negativa com CMS e controle de direção látero-lateral. Conclusões: As variáveis de composição corporal não interferem nos testes de LE e TRP em indivíduos que apresentam valores de índice de massa corporal (IMC) dentro da normalidade, exceto a densitometria óssea (DMO) em mulheres. Quanto aos parâmetros antropométricos, estatura, CMS e tamanho dos pés no grupo feminino e no masculino foram os seguintes: CMS e tamanho dos pés têm pouca influência no controle do equilíbrio postural. Nível de evidência II, Estudos diagnósticos – Investigação de um exame para diagnóstico.

ABSTRACT Introduction: The limit of stability is characterized by the maximum angle of inclination that an individual can reach and greater variability in extreme conditions; it is a bold and/or dangerous motor control strategy. Objective: Assess whether anthropometric measurements and body composition interfere with limits of stability and weight-bearing at different speeds in adults. Methods: Eighty-seven subjects of both sexes aged between 20 and 40 years were analyzed using anthropometric assessment and body composition. A force platform, limits of stability (LoS) and rhythmic weight shift (RWS) tests were used for the balance assessments. Results: In the LoS test, being female was negatively correlated with foot size and reaction time, and positively correlated with maximum excursion. In the RWS test, the female group had a negative correlation with height and upper limb length (ULL), with mediolateral directional control. The male group had a negative correlation with ULL and laterolateral directional control. Conclusion: Body composition variables do not interfere in the LoS and RWS tests in subjects with normal body mass index (BMI) values, except for bone densitometry (BMD) in women. As regards anthropometric parameters, height, ULL and foot size in the female and male groups were as follows: ULL and foot size exert little influence on postural balance control. Level of evidence II, Diagnostic studies - Investigation of a diagnostic test.

RESUMEN Introducción: El límite de estabilidad se caracteriza por el ángulo de inclinación máximo que puede alcanzar un individuo y por la mayor variabilidad en condiciones extremas; se trata de una estrategia audaz y/o peligrosa de control motor. Objetivos: Evaluar si las medidas antropométricas y la composición corporal interfieren en los límites de estabilidad y en las descargas de peso en diferentes velocidades en adultos. Métodos: Fueron analizados 87 individuos de ambos sexos, entre 20 a 40 años de edad, por medio de evaluación antropométrica y composición corporal. Para las evaluaciones de equilibrio se usaron una plataforma de fuerza, tests de límite de estabilidad (LE) e intercambio rítmico de peso (IRP). Resultados: En el test de LE, el sexo femenino se correlacionó negativamente con el tamaño del pie y el tiempo de reacción y positivamente con la excursión máxima. En el IRP el grupo femenino presentó correlación negativa con estatura y longitud de miembros superiores (LMS) con control de dirección medio-lateral. El grupo masculino presentó correlación negativa con LMS y control de dirección latero-lateral. Conclusiones: Las variables de composición corporal no interfieren en los tests LE y IRP en individuos que presentan valores de índice de masa corporal (IMC) dentro de la normalidad, excepto la densitometría ósea (DMO) en mujeres. Sobre los parámetros antropométricos, estatura, LMS y tamaño de los pies en el grupo femenino y en el masculino fueron los siguientes: LMS y tamaño de los pies tienen poca influencia en el control del equilibrio postural. Nivel de evidencia II, Estudios diagnósticos - Investigación de un examen para diagnóstico.

RESUMO Objetivo: relatar uma série de casos de cirurgia bariátrica robótica no tratamento da obesidade no Brasil. Métodos: foram avaliados pacientes submetidos à cirurgia bariátrica robótica no Instituto Garrido, e realizada comparação com grupo submetido à cirurgia laparoscópica convencional. Resultados: foram analisados 45 pacientes, com média de idade de 39,44 anos, sendo 34 do sexo feminino, com média de IMC inicial de 41,26Kg/m2. Dentre as cirurgias realizadas, 91,11% foram bypass gástrico em Y de Roux, enquanto 8,89% foram do tipo gastrectomia vertical. A média de tempo total de cirurgia foi de 158 (±56,54) minutos, com tempo médio de docking de 7,93 (±3,9) minutos e tempo de console 113,0 (±41,4) minutos. A média de dor apresentada na recuperação pós-anestésica foi de 2,61 (±3,30) pontos, em escala de 0 a 10, com quatro pacientes apresentando sinais leves de náusea, respondendo bem ao tratamento medicamentoso. Somente um paciente necessitou internação em UTI por um período de dois dias após a cirurgia, devido à cardiopatia prévia. Em dois casos ocorreram hérnia incisional em sítio de trocater, tratados cirurgicamente, sem posteriores complicações. Na comparação entre os grupos de cirurgia robótica versus laparoscópica, foram selecionados 45 pacientes para cada grupo. O tempo operatório foi significativamente mais longo na via robótica, sendo a maior parte das outras variáveis equivalentes, inclusive controle pós-operatório de comorbidades. Conclusão: a cirurgia bariátrica robótica é um procedimento seguro, com resultados comparáveis à cirurgia laparoscópica.

ABSTRACT Objective: to report a series of cases of robotic bariatric surgery in the treatment of obesity in Brazil. Methods: we evaluated patients undergoing robotic bariatric surgery at the Garrido Institute and compared them with a group submitted to conventional laparoscopic surgery. Results: we analyzed 45 patients, with a mean age of 39.44 years, of which 34 were female, with an initial mean BMI of 41.26kg/m2. Among the procedures performed, 91.11% were Roux-en-Y gastric bypass, while 8.89% were sleeve gastrectomy. The mean total surgery time was 158 (±56.54) minutes, with mean docking time of 7.93 (±3.9) minutes, and console time 113.0 (±41.4) minutes. The average pain presented in the post anesthetic recovery was 2.61 (±3.30) points on a scale of 0 to 10; four patients presented with mild signs of nausea, responding well to drug treatment. Only one patient needed ICU admission for a period of two days after surgery due to previous cardiopathy. In two cases, there was an incisional hernia at the trocar site, which were surgically treated without further complications. In the comparison between robotic versus laparoscopic surgery groups, 45 patients were selected for each group. Operative time was significantly longer in the robotic surgery group, with most other variables being equivalent, including postoperative control of comorbidities. Conclusion: robotic bariatric surgery is a safe procedure, with results comparable to laparoscopic surgery.

OBJECTIVE: To assess the postural control and flexibility of obese subjects before and both six and 12 months after bariatric surgery. To verify whether postural control is related to flexibility following weight reductions resulting from bariatric surgery. METHODS: The sample consisted of 16 subjects who had undergone bariatric surgery. All assessments were performed before and six and 12 months after bariatric surgery. Postural balance was assessed using an Accusuway¯ portable force platform, and flexibility was assessed using a standard chair sit and reach test (Wells’ chair). RESULTS: With the force platform, no differences were observed in the displacement area or velocity from the center of pressure in the mediolateral and anteroposterior directions. The displacement speed from the center of pressure was decreased at the six month after the surgery; however, unchanged from baseline at 12 months post-surgery. Flexibility increased over time according to the three measurements tested. CONCLUSIONS: Static postural balance did not change. The velocity of postural adjustment responses were increased at six months after surgery. Therefore, weight loss promotes increased flexibility. Yet, improvements in flexibility are not related to improvements in balance.

OBJECTIVE: The aim of this study was to evaluate the vertical component of the ground reaction force, plantar pressure, contact area of the feet and double-support time using static and dynamic (gait) baropodometry before and after bariatric surgery. METHODS: Sixteen individuals with a body mass index of between 35 and 55 were evaluated before and after bariatric surgery. Thirteen patients (81.3%) were female and three (18.8%) male and their average age was 46±10 (21-60) years. An FSCAN system (version 3848) was used for baropodometric analyses (1 km/h and 3 km/h). The peak plantar pressure and ground reaction force were measured for the rear foot and forefoot. The double-support time and foot contact area were measured during gait. RESULTS: There were reductions in the ground reaction force in the forefoot and rear foot and in the foot contact area in all evaluations and of the double-support time at 3 km/h, as well as a significant reduction in the body mass index at six months post-surgery. The peak pressure did not vary at 1 km/h and at 3 km/h, reductions in peak pressure were observed in the left and right rear feet and left forefoot. CONCLUSIONS: Weight loss after bariatric surgery resulted in decreases in the ground reaction force and contact area of the foot. Plantar pressure was decreased at 3 km/h, especially in the forefoot. There was an increase in rhythm because of a reduction in the double-support time at 3 km/h.