ABSTRACT Introduction: Functional incapacity caused by physical alterations leads to significant limitations in daily activities and has a major impact on the return of people with disabilities to the social space and the workplace. This calls for an evaluation of the long-term influence of the use of a device specially developed for orthostatic posture on the physiological, biomechanical and functional parameters of amputees and spinal cord patients. Objective: The objective was evaluate the effect of postural support device use on function, pain, and biomechanical and cardiologic parameters in spinal cord injury and amputees patients compared to a control group. Methods: The orthostatic device was used by the participants for a period of ten consecutive days, for three cycles of 50 minutes each day, and a 15-day follow-up. Participants were positioned and stabilized using adjustable straps on the shoulders, trunk, and hips. The primary outcome was brief pain inventory. Fifteen participants were included the control group, 15 in the amputee group, and 15 in the spinal cord group. Results: Our results demonstrate that the use of the device allows the orthostatic position of amputees and spinal cord patients evaluated for ten days, leading to improved functionality and pain in the spinal cord and amputee groups compared to the control group. In addition, no changes were observed for secondary outcomes, indicating that the use of the device did not cause harm interference to patients. Conclusion: The long-term use of the orthostatic device is beneficial for improving functionality, reduce pain in amputees and spinal cord injury patients. Level of evidence II; Therapeutic Studies - Investigating the results of treatment. Introduction workplace longterm long term physiological Objective function group Methods days 5 day 15day followup. followup follow up. up follow-up shoulders trunk hips inventory 1 Results addition outcomes Conclusion II treatment

RESUMO Introdução: A incapacidade funcional causada por alterações físicas leva a limitações significativas nas atividades diárias e gera um grande impacto no retorno das pessoas com deficiência ao espaço social e ao local de trabalho, demandando a avaliação da influência em longo prazo do uso de um dispositivo especialmente desenvolvido para a postura ortostática nos parâmetros fisiológicos, biomecânicos e funcionais de pacientes amputados e com medula espinhal. Objetivo: O objetivo foi avaliar o efeito do uso do dispositivo de suporte postural na função, dor e parâmetros biomecânicos e cardiológicos em pacientes com lesão medular e amputados em comparação com um grupo controle. Métodos: O aparelho ortostático foi utilizado pelos participantes por um período de dez dias consecutivos, em três ciclos de 50 minutos diários, com acompanhamento de 15 dias. Os participantes foram posicionados e estabilizados por meio de alças ajustáveis nos ombros, tronco e quadris. O desfecho primário foi o questionário Breve Inventário de Dor. Quinze participantes foram incluídos no grupo controle, 15 no grupo amputado e 15 no grupo medular. Resultados: Nossos resultados demonstram que o uso do dispositivo permite a posição ortostática de amputados e pacientes com lesão medular avaliados por dez dias, levando a melhora da funcionalidade e dor nos grupos de amputados e medula espinhal em relação ao grupo controle. Além disso, não foram observadas alterações nos resultados secundários, indicando que o uso do dispositivo não causou interferência prejudicial aos pacientes. Conclusão: O uso prolongado do dispositivo ortostático é benéfico para melhorar a funcionalidade, reduzir a dor em amputados e pacientes com lesão medular. Nível de Evidência II; Estudos Terapêuticos - Investigação dos resultados de tratamento. Introdução trabalho fisiológicos Objetivo função controle Métodos consecutivos 5 diários 1 ombros quadris Dor Resultados disso secundários Conclusão II tratamento

RESUMO Objetivo: Avaliar a dependência do smartphone e a alteração postural da região cervical em adolescentes. Métodos: Estudo transversal, com 281 adolescentes (15 a 19 anos), que frequentavam da 1ᵃ à 3ᵃ série do ensino médio, realizado entre setembro e outubro de 2019 na cidade de Fortaleza, Ceará, Brasil. A coleta dos dados ocorreu em duas etapas. Na primeira, eles responderam a quatro questionários autoaplicáveis: questionário sociodemográfico, condições de saúde e uso do smartphon e, Questionário Nórdico de Sintomas Musculoesqueléticos (NMQ), Self-Report Questi onnaire (SRQ-20) e o Smartphone A ddiction Inventory (SPAI-BR). Na segunda etapa, foram submetidos a fotogrametria pelo Software de Avaliação Postural (SAPO) e avaliação antropométrica (peso e altura). Para a análise dos dados, foi utilizado o SPSS Statistics versão 23.0. Resultados: Do total, 63,3% (n=178) dos adolescentes apresentaram dependência do smartphone, com o uso de 5,8 horas (±3,5) durante a semana e 8,7 (±4,0) no fim de semana. Ao analisar o alinhamento postural na visão anterior, observou-se redução significativa da inclinação lateral de cabeça ao digitar no smartphon e (p=0,002) comparado à posição anatômica (baseline). Na visão lateral foi constatado aumento da anteriorização de cabeça durante o uso do smartphon e (p<0,05). Houve associação da dependência do smartphone com a anteriorização de cabeça (p<0,05). Conclusões: O uso do smartphone na posição de digitação causa alteração postural na região cervical, destacadamente naqueles que apresentam dependência do dispositivo. Dessa forma, são necessárias medidas de promoção de saúde que alertem os adolescentes sobre os efeitos adversos causados pelo uso prolongado do smartphone. Objetivo Métodos transversal 28 15 (1 1 anos, anos , anos) ᵃ médio 201 Fortaleza Ceará Brasil etapas primeira autoaplicáveis sociodemográfico NMQ, NMQ (NMQ) SelfReport Self Report SRQ20 SRQ 20 (SRQ-20 SPAIBR. SPAIBR SPAI BR . (SPAI-BR) etapa SAPO (SAPO peso altura. altura altura) 230 23 0 23.0 Resultados total 633 63 3 63,3 n=178 n178 n 178 (n=178 58 5 8 5, ±3,5 35 (±3,5 87 7 8, ±4,0 40 4 (±4,0 anterior observouse observou se p=0,002 p0002 p 002 (p=0,002 baseline. baseline (baseline) p<0,05. p005 p<0,05 05 (p<0,05) Conclusões dispositivo forma 2 ( (NMQ SRQ2 (SRQ-2 (SPAI-BR 23. 6 63, n=17 n17 17 (n=17 ±3, (±3, ±4, (±4, p=0,00 p000 00 (p=0,00 (baseline p00 p<0,0 (p<0,05 (SRQ- n=1 n1 (n=1 ±3 (±3 ±4 (±4 p=0,0 (p=0,0 p0 p<0, (p<0,0 (SRQ n= (n= ± (± p=0, (p=0, p<0 (p<0, (n p=0 (p=0 p< (p<0 p= (p= (p< (p

ABSTRACT Objective: To evaluate smartphone addiction and postural alterations in the cervical region in adolescents. Methods: A cross-sectional study with 281 adolescents (15 to 19 years old), attending the 1st to the 3rd grades of High School, carried out between September and October 2019 in the city of Fortaleza, Ceará, Brazil. Data collection took place in two stages. In the first, they answered four self-administered questionnaires: sociodemographic questionnaire, health conditions and smartphone use, Nordic Musculoskeletal Symptom Questionnaire (NMQ), Self-Report Questionnaire (SRQ-20) and the Smartphone Addiction Inventory (SPAI-BR). In the second stage, they were submitted to photogrammetry using the Postural Assessment Software (SAPO) and anthropometric assessment (weight and height). The software SPSS Statistics version 23.0 was used for data analysis. Results: Of the total number of adolescents, 63.3% (n=178) showed smartphone addiction, using it for 5.8 hours (±3.5) during the week and 8.7 (±4.0) hours on the weekend. When analyzing postural alignment in the anterior view, a significant reduction in the lateral head tilt was observed when typing on the smartphone (p=0.002) compared to the anatomical position (baseline). In the lateral view, an increase in head anteriorization was observed during smartphone use (p<0.05). There was an association between smartphone addiction and head anteriorization (p<0.05). Conclusions: The use of the smartphone in the typing position causes postural alterations in the cervical region, especially in adolescents with smartphone addiction. Therefore, health promotion measures that alert adolescents to the adverse effects caused by prolonged smartphone use are necessary. Objective Methods crosssectional cross sectional 28 15 (1 1 old, old , old) st rd School 201 Fortaleza Ceará Brazil stages first selfadministered self administered questionnaires questionnaire NMQ, NMQ (NMQ) SelfReport Self Report SRQ20 SRQ 20 (SRQ-20 SPAIBR. SPAIBR SPAI BR . (SPAI-BR) stage SAPO (SAPO weight height. height height) 230 23 0 23. analysis Results 633 63 3 63.3 n=178 n178 n 178 (n=178 58 5 8 5. ±3.5 35 (±3.5 87 7 8. ±4.0 40 4 (±4.0 weekend view p=0.002 p0002 p 002 (p=0.002 baseline. baseline (baseline) p<0.05. p005 p<0.05 05 (p<0.05) Conclusions Therefore necessary 2 ( (NMQ SRQ2 (SRQ-2 (SPAI-BR 6 63. n=17 n17 17 (n=17 ±3. (±3. ±4. (±4. p=0.00 p000 00 (p=0.00 (baseline p00 p<0.0 (p<0.05 (SRQ- n=1 n1 (n=1 ±3 (±3 ±4 (±4 p=0.0 (p=0.0 p0 p<0. (p<0.0 (SRQ n= (n= ± (± p=0. (p=0. p<0 (p<0. (n p=0 (p=0 p< (p<0 p= (p= (p< (p

Abstract Introduction: Persistent Postural Perceptual Dizziness (PPPD) is one of the most common causes of chronic vertigo. While patients with PPPD have spatial perception alterations, it is unknown whether they present alterations in fear of heights. To avoid exposing patients with PPPD to high places, we aimed to use virtual reality to quantify fear of heights. Aim: To quantify fear of heights in patients with PPPD and controls using simulated environments with virtual reality. Material and Method: A prospective cross-sectional study of age- and sex-matched case-control pairs. PPPD patients were recruited from the Otolaryngology Service of the Clinical Hospital of the University of Chile between 2020 and 2021. Presence of subjective fear and tachycardia were measured. The scenarios were developed using Blender 2.8 and Oculus Link for the Oculus Quest. Five scenarios at different heights (floors 1, 3, 6, 12, 19) were used. Results: Twenty subjects were recruited (12 women, average age of 47 years), including 10 PPPD patients and 10 controls without vestibular symptoms. None of the control group subjects presented fear in the presented scenarios, while seven patients in the PPPD group had subjective fear at a height lower than virtual 40 meters (Fischer, p < 0.05). Conclusion: Patients with PPPD present a greater proportion of subjective fear to heights than controls, but further studies are required to determine if this fear is specific to PPPD or is general to other causes of chronic vertigo.

Resumen Introducción: El mareo postural perceptual persistente (MPPP) es una de las causas más frecuentes de vértigo crónico. Si bien, los pacientes con MPPP tienen alteraciones de la percepción espacial, se desconoce si presentan alteraciones en el miedo a las alturas. Para no exponer a pacientes con MPPP a ambientes reales con altura, nos propusimos utilizar la realidad virtual para estudiar el miedo a las alturas. Objetivo: Cuantificar el miedo a las alturas en pacientes con MPPP y controles mediante ambientes simulados con realidad virtual. Material y Método: Estudio transversal, prospectivo de casos y controles pareados por edad y sexo. Se reclutaron pacientes con MPPP del Servicio de Otorrinolaringología del Hospital Clínico de la Universidad de Chile entre los años 2020 y 2021. Se midió presencia subjetiva de miedo y taquicardia. Los escenarios se desarrollaron con el programa Blender 2.8 y Oculus Link para equipo Oculus Quest. Se utilizaron cinco escenarios a diferentes alturas (pisos 1, 3, 6, 12, 19). Resultados: Se reclutaron 20 sujetos (12 mujeres, 47 años en promedio), incluyendo 10 pacientes con MPPP y 10 controles sin síntomas vestibulares. Ningún sujeto del grupo control presentó miedo en los escenarios presentados, mientras que siete pacientes del grupo MPPP tuvieron miedo subjetivo a una altura menor a 40 metros virtuales (Fischer, p < 0,05). Conclusión: Los pacientes con MPPP presentan, con mayor frecuencia, miedo subjetivo a las alturas que los controles, pero se requiere de nuevos estudios para determinar si este miedo es específico de MPPP, o es general a otras causas de vértigo crónico.

Abstract Introduction: Persistent postural-perceptual dizziness (PPPD) is probably the most prevalent cause of chronic dizziness. However, its pathophysiology is still a matter of uncertainty and debate. In this article, we propose that PPPD is characterized by higher-order cognitive dysfunctions, to the point of differentiating it from healthy controls and patients with non-PPPD vestibular pathologies. Aim: To determine whether patients with PPPD exhibit discriminant alterations compared to control groups in the areas of attention, visuospatial working memory, spatial planning, executive functions, and global cognitive performance. Materials and Methods: A cross-sectional descriptive study was conducted with subjects between the ages of 18 and 65 years, recruited from an outpatient otoneurology unit. Tests included the Montreal Cognitive Assessment (MoCA), digit retention task, Trail Making Test, Corsi Block-Tapping Task, and the Tower of London. Results: 30 patients were categorized into three groups: PPPD group (n = 14), non-PPPD vestibular group (n = 11), and control group (n = 5). The PPPD group showed significantly lower performance on tests of planning, processing speed, and executive function in visuospatial domains, while there were no differences between groups in attention and visuospatial memory. Conclusion: PPPD may be characterized by dysfunction of higher-order cognitive processes related to spatial construction of greater complexity, while sparing lower-order visuospatial functions such as working memory. These findings offer new insights into the pathophysiology of PPPD and its clinical implications.

Resumen Introducción: El mareo perceptual postural persistente (MPPP) es, probablemente, la causa más prevalente de mareo crónico. Sin embargo, su fisiopatología es aún motivo de duda y debate. En el presente artículo, proponemos que el MPPP se caracteriza por disfunciones cognitivas de orden superior, al punto de diferenciarse en estas dimensiones de controles sanos y pacientes con patologías vestibulares no-MPPP. Objetivo: Determinar si pacientes con MPPP presentan alteraciones discriminantes respecto a grupos controles, en ámbitos de atención, memoria de trabajo visoespacial, planificación espacial, funciones ejecutivas y rendimiento cognitivo global. Material y Método: Estudio descriptivo transversal con sujetos de entre 18 y 65 años, reclutados de una unidad de otoneurología ambulatoria. Se aplicaron pruebas Montreal Cognitive Assessment (MoCA), tarea de retención de dígitos, Trail Making Test, Corsi Block-Tapping Task y Torre de Londres. Resultados: 30 pacientes fueron categorizados en tres grupos: grupo MPPP (n = 14), grupo vestibular no-MPPP (n = 11) y grupo control (n = 5). El grupo MPPP exhibió un rendimiento significativamente inferior en pruebas de planificación, velocidad de procesamiento y funciones ejecutivas en ámbitos visoespaciales, mientras que en atención y memoria visoespacial no hubo diferencias entre grupos. Conclusión: El MPPP podría caracterizarse por una disfunción de procesos cognitivos superiores de construcción espacial de mayor complejidad, respetando funciones visoespaciales de menor orden como la memoria de trabajo. Estos hallazgos ofrecen nuevas luces para comprender la fisiopatología del MPPP y sus implicancias clínicas.

ABSTRACT Cerebral palsy is one of the most frequent diseases in children and the most common cause of disability as a consequence of a brain injury that generates a disorder of motor development. The research presents the results of a review on Cerebral palsy, the main alterations of movement and posture, physiotherapeutic principles and mechanisms by which hydrotherapy helps to improve them. The stated objective was to describe the benefits of hydrotherapy on mobility and posture in children with cerebral palsy. For its fulfillment, the research carried out is descriptive, non-experimental and cross-sectional. The sample included 23 studies published as of 2017 in Google Scholar, in regional databases SciELO, Latindex, Redalyc, and in international databases of high scientific rigor PubMed and Medline. The main contributions on the subject include: the affectations that children with cerebral palsy present in relation to their mobility and the maintenance of an adequate posture, as well as the mechanisms and physiotherapeutic principles by which hydrotherapy helps to improve mobility and posture in children with this pathology. It is concluded that the alterations can be improved with the use of physiotherapeutic methods. hydrotherapy is recognized as one of the interventions that provides benefits to children with this pathology due to the properties of water and the physiological mechanisms that help improve mobility and posture in children with this disease.

RESUMEN La parálisis cerebral es una de las enfermedades más frecuentes en niños y la causa más común de discapacidad causada por lesión cerebral que genera un trastorno del desarrollo motor. En la investigación se exponen los resultados de una revisión sobre la parálisis cerebral, las principales alteraciones del movimiento y la postura, principios y mecanismos fisioterapéuticos por los que la hidroterapia ayuda a mejorarlos. El objetivo planteado fue describir los beneficios de la hidroterapia en la movilidad y la postura en niños con parálisis cerebral. Se trata de una investigación descriptiva, no experimental y de corte transversal. La muestra incluyó 22 estudios publicados a partir del 2017 en Google académico, en bases de datos regionales SciELO, Latindex, Redalyc y en bases internacionales de alto rigor científico PubMed y Medline. Los principales aportes sobre el tema incluyen: las afectaciones que presentan los niños con parálisis cerebral en relación a su movilidad y el mantenimiento de una adecuada postura, asimismo los mecanismos y principios fisioterapéuticos por los cuales la hidroterapia ayuda a mejorar la movilidad y la postura en los niños con esta patología. Se concluye las alteraciones pueden ser mejoradas con la utilización de métodos fisioterapéuticos. La hidroterapia se reconoce como una de las intervenciones que aporta beneficios a los niños con esta patología por las propiedades del agua y los mecanismos fisiológicos que ayudan a mejorar la movilidad y la postura en niños con esta enfermedad.

RESUMO JUSTIFICATIVA E OBJETIVOS: A amputação é um evento que acarreta consequências que podem afetar o cotidiano, entre elas a dor, potencializando alterações, seja no sono ou na qualidade de vida. O objetivo deste estudo foi avaliar o limiar de dor por pressão (LDP) em pessoas com amputação submetidas ao uso de diferentes equipamentos de elevação postural. MÉTODOS: Estudo experimental cruzado, realizado de setembro a outubro de 2022, com pessoas com amputação no membro inferior (n=15) e pessoas sem amputação (n=15). Foram avaliados o LDP em quatro regiões (T12-L1, L5-S1, tuberosidade anterior da tíbia e calcâneo) pré e pós uso de distintas versões (A e B) de um equipamento de elevação postural, gravidade e interferência da dor. Presença de sinais e sintomas de sensibilização central (SC) e qualidade do sono. RESULTADOS: Os grupos não apresentaram alterações no LDP quando comparados em relação às diferentes versões do equipamento (p<0,05) nos quatro locais analisados. Além disso, os grupos não mostraram diferenças em relação aos dias de avaliação ou entre si quanto a severidade e interferência de dor e presença de sinais e sintomas de SC. O grupo controle indicou uma qualidade de sono ruim (p=0,0173) e manteve-se pior que as pessoas com amputação. CONCLUSÃO: As versões do equipamento não alteraram o LDP nas áreas analisadas. Os grupos não apresentaram diferença entre si, sugerindo que o equipamento promoveu respostas semelhantes, ou seja, não foi evidenciada uma alteração de sensibilidade nas regiões que possuem maior contato com elementos de estabilização e descarga de peso dos equipamentos. OBJETIVOS cotidiano vida (LDP postural MÉTODOS cruzado 2022 n=15 n15 n 15 (n=15 n=15. . T12L1, T12L1 TL T12 L1, L1 T L (T12-L1 L5S1, L5S1 LS L5 S1, S1 S L5-S1 calcâneo B SC (SC RESULTADOS p<0,05 p005 p 0 05 (p<0,05 analisados disso p=0,0173 p00173 0173 (p=0,0173 mantevese manteve se CONCLUSÃO analisadas semelhantes 202 n=1 n1 1 (n=1 T12L T1 (T12-L L5S L5-S p<0,0 p00 (p<0,0 p=0,017 p0017 017 (p=0,017 20 n= (n= p<0, p0 (p<0, p=0,01 p001 01 (p=0,01 2 (n p<0 (p<0 p=0,0 (p=0,0 p< (p< p=0, (p=0, (p p=0 (p=0 p= (p=

ABSTRACT BACKGROUND AND OBJECTIVES: Amputation is an event that has consequences that can affect daily life, including pain, enhancing changes, whether in sleep or in quality of life. The objective of this study was to evaluate the pressure pain threshold (PPT) in people with amputations submitted to the use of different postural elevation equipment. METHODS: Experimental crossover study, carried out from September to October 2022, with people with lower limb amputation (n=15) and people without amputation (n=15). PPT in four regions (T12-L1, L5-S1, anterior tuberosity of the tibia and calcaneus) were evaluated before and after the use of different versions (A and B) of an equipment for postural elevation, gravity and pain interference. Presence of signs and symptoms of central sensitization (CS) and sleep quality. RESULTS: The groups did not present PPT alterations when compared between the different versions of the equipment (p<0.05) in the four locations analyzed. Furthermore, the groups did not show differences in relation to the evaluation days or among themselves regarding the severity and interference of pain and the presence of signs and symptoms of CS. The control group indicated poor sleep quality (p=0.0173) and remained worse than people with amputation. CONCLUSION: The versions of the equipment did not change PPT in the analyzed areas. The groups did not differ between themselves, suggesting that the equipment promoted similar responses, that is, no change in sensitivity was evidenced in the analyzed regions which have greater contact with stabilization elements and weight discharge of the equipment. OBJECTIVES life changes (PPT METHODS 2022 n=15 n15 n 15 (n=15 n=15. . T12L1, T12L1 TL T12 L1, L1 T L (T12-L1 L5S1, L5S1 LS L5 S1, S1 S L5-S1 calcaneus A B CS (CS RESULTS p<0.05 p005 p 0 05 (p<0.05 Furthermore p=0.0173 p00173 0173 (p=0.0173 CONCLUSION areas responses 202 n=1 n1 1 (n=1 T12L T1 (T12-L L5S L5-S p<0.0 p00 (p<0.0 p=0.017 p0017 017 (p=0.017 20 n= (n= p<0. p0 (p<0. p=0.01 p001 01 (p=0.01 2 (n p<0 (p<0 p=0.0 (p=0.0 p< (p< p=0. (p=0. (p p=0 (p=0 p= (p=

Resumen Introducción: La escoliosis es una deformidad de la columna que usualmente se manifiesta como una curva estructural que determina una deformidad variable del tronco. Las malformaciones de Chiari se caracterizan por la herniación descendente de las amígdalas cerebelosas, tronco encefálico y IV ventrículo hacia el canal espinal. Según algunas series publicadas, del 4 al 26% de las escoliosis inicialmente catalogadas como idiopáticas muestran alteraciones neurológicas al ser estudiadas con resonancia magnética nuclear, como la siringomielia y malformación de Chiari, dentro de las más frecuentes. Caso clínico: Se presenta el caso de un paciente cuya primera manifestación sintomática fue escoliosis de comienzo temprano. El solapamiento de algunos signos del examen físico, como la lateralización de la postura y la escoliosis, reforzaron la sospecha activa de alteraciones del neuroeje. Conclusiones: La escoliosis de inicio temprano en la infancia debe despertar un alto grado de sospecha de asociación con enfermedades neuro-espinales. Dentro de este contexto, aunque malformación Chiari es de baja frecuencia, su abordaje precoz permitiría disminuir la progresión de comorbilidades asociadas. La detección temprana podría cambiar el pronóstico de la enfermedad.

Abstract Background: Scoliosis is a spinal deformity that usually manifests as a structural curve determining a variable deformity of the trunk. According to some published series, 4 to 26% of scoliosis initially classified as idiopathic show neurological alterations when studied with nuclear magnetic resonance, such as syringomyelia and Chiari malformation, among the most frequent. Chiari malformations are characterized by descending herniation of the cerebellar tonsils, brainstem, and IV ventricle into the spinal canal. Case report: We present the case of a patient whose first symptomatic manifestation was early-onset scoliosis. The overlapping of some physical examination signs, such as postural lateralization and scoliosis, reinforced the active suspicion of neuroaxis alterations. Conclusions: Early childhood-onset scoliosis should raise a high degree of suspicion for association with neuro-spinal diseases. Although the frequency of Chiari malformation is low, its early approach could reduce the progression of associated comorbidities. An early detection could change the prognosis of the disease.

ABSTRACT Introduction: Older adults, by nature, present progressive deterioration of physical-cognitive abilities where faculties such as balance and gait are affected, conditioning the increased risk of falling. Objective: To evaluate balance and walk in a sample of older adults belonging to the family doctor's office No.21, of the Julio Antonio Mella Community Teaching Polyclinic, in the Camagüey province. Methods: A descriptive study of cross-sectional design was carried out. The universe consisted of 468 older adults and an intentional sample of 100 was selected according to inclusion and exclusion criteria. The primary source of the research being the observation and the interview, the secondary source the family and individual health histories and a form with the following variables: age groups, sex, educational level, comorbidities, medication use, history of falls, evaluation of balance, gait evaluation and evaluation of the risk of falls, applying the Tinetti scale. Results: There was a greater frequency in adults aged 70-79 years, female and with a pre-university educational level. Arterial hypertension predominated, consuming between one and three medications and with a history of up to two previous falls. Alterations in the evaluation of balance and gait were demonstrated, showing according to the Tinetti scale that the sample presents a moderate risk of suffering falls with a greater predisposition in the female sex. Conclusions: The group of elderly adults evaluated present alterations in the evaluation of balance and gait, with a moderate risk of falling, with its consequences if effective measures are not taken in this regard.

RESUMEN Introducción: Los adultos mayores por naturaleza presentan deterioro progresivo de las capacidades físico-cognitivas, donde se ven afectadas facultades como el equilibrio y la marcha, condicionando el aumento del riesgo de sufrir caídas. Objetivo: Evaluar el equilibrio y la marcha en una muestra de adultos mayores pertenecientes al consultorio del médico de la familia No. 21, del Policlínico Comunitario Docente Julio Antonio Mella, de la provincia Camagüey. Métodos: Se realizó un estudio descriptivo de diseño transversal. El universo estuvo constituido por 468 adultos mayores y se seleccionó una muestra intencionada de 100 de ellos, según los criterios de inclusión y exclusión. La observación y la entrevista fueron las fuentes primarias de la investigación. Las historias de salud familiar e individual fueron la fuente secundaria, además de un formulario con las siguientes variables: grupos etáreos, sexo, nivel educacional, comorbilidades, consumo de medicamentos, antecedentes de caídas, evaluación del equilibrio, evaluación de la marcha y la evaluación del riesgo de caídas, aplicando la escala de Tinetti. Resultados: Existió mayor frecuencia en los adultos mayores de 70-79 años, del sexo femenino y con nivel educacional preuniversitario. Predominó la hipertensión arterial (consumiendo entre uno y tres medicamentos) y con antecedentes de hasta dos caídas anteriores. Se demostraron alteraciones en la evaluación del equilibrio y la marcha, según la escala de Tinetti, el grupo de pacientes presentó un riesgo moderado de sufrir caídas, con una mayor predisposición para el sexo femenino. Conclusiones: El grupo de adultos mayores evaluados presentó alteraciones en la evaluación del equilibrio y la marcha, con un moderado riesgo de sufrir caídas, evitando así las consecuencias que tiene cada precipitación si no se toman las medidas efectivas al respecto.

Resumo Introdução: A crescente inserção das mulheres no mercado de trabalho ocasionou uma necessidade de adaptação das bolsas, com tamanhos e pesos diferentes, que por consequência podem sobrecarregar o sistema musculoesquelético. Objetivo: Avaliar o efeito do uso da bolsa unilateral nas pressões plantares e no equilí-brio estático em mulheres. Métodos: Estudo transversal, realizado na cidade de Fortaleza em 2018. Participaram 258 mulheres com idade entre 18 e 59 anos e que usavam bolsa unilateral. Aplicaram-se dois questionários visando as variáveis sociodemográficas, hábitos de vida, características do uso da bolsa e nível de atividade física. Foram mensuradas estatura, simetria escapular, massa corporal e da bolsa. Utilizou-se baropodômetro para a avaliação das pressões plantares e equilíbrio estático com e sem a bolsa unilateral. Aplicaram-se testes t de amostras independentes e pareado para verificar a influência da bolsa nas variáveis de interesse, pelo programa SPSS Statistics (versão 23.0). Resultados: No lado que a bolsa era carregada foram observados aumento da distribuição de massa lateral (DML), da pressão do pé e da área de superfície e diminuição da distância do baricentro (p < 0,05). No lado oposto foram detectados diminuição da DML e aumento do baricentro (p < 0,05). No equilíbrio estático, não foram verificadas diferenças nas oscilações ântero-posterior e látero-lateral com a colocação da bolsa (p > 0,05). Conclusão: A bolsa unilateral causa alterações nas pressões plantares e no baricentro homolaterais no lado do uso da bolsa, sendo um fator de risco ou agravamento para as disfunções do sistema musculoesquelético e para a ocorrência de dor. Introdução bolsas diferentes Objetivo equilí brio Métodos transversal 2018 25 1 5 Aplicaramse Aplicaram se sociodemográficas vida física estatura escapular Utilizouse Utilizou interesse versão 23.0. 230 23.0 . 23 0 23.0) Resultados DML, , (DML) p 0,05. 005 0,05 05 0,05) ânteroposterior ântero posterior láterolateral látero Conclusão dor 201 2 23. (DML 00 0,0 20 0,

Abstract Introduction: The increasing insertion of women into the labor market has created a need to adapt handbags, with different sizes and weights, which consequently can overload the musculoskeletal system. Objective: To evaluate the effect of using a unilateral bag on plantar pressures and static balance in women. Methods: Cross-sectional study, carried out in Fortaleza in 2018. 258 women aged between 18 and 59 years who used a unilateral bag participated in this study. Two questionnaires were applied, targeting sociodemographic variables, life habits, characteristics of bag use and level of physical activity. Height, scapular symmetry, body and bag mass were also measured. A baropodometer was used to assess plantar pressure and static balance with and without the unilateral bag. Independent and paired t-tests were applied to verify the influence of the bag on the variables of interest, using the SPSS Statistics program (version 23.0). Results: On the side where the bag was carried, an increase in lateral mass distribution (LMD), foot pressure and surface area, and a decrease in the distance from barycenter (p < 0.05) were observed. On the opposite side, a decrease in LMD and an increase in barycenter were detected (p < 0.05). In static balance, no differences were observed in the anteroposterior and side-to-side oscillations with bag placement (p > 0.05). Conclusion: The unilateral bag causes alterations in plantar pressures and ipsilateral barycenter alongside the use of the bag, being a risk factor or aggravation for dysfunctions of the musculoskeletal system and for the occurrence of pain. Introduction handbags weights Objective Methods Crosssectional Cross sectional study 2018 25 1 5 habits activity Height symmetry measured ttests t tests interest version 23.0. 230 23.0 . 23 0 23.0) Results LMD, , (LMD) area p 0.05 005 05 0.05. sidetoside Conclusion pain 201 2 23. (LMD 0.0 00 20 0.

Resumo A obesidade é considerada fator de risco à saúde e além de gerar alterações metabólicas e cardiovasculares, está relacionada a complicações mecânicas. Uma vez que a estabilidade pode estar alterada em função de fatores antropométricos e biomecânicos, ainda são escassos os estudos que investigam a relação do excesso de peso sobre a modilidade e equilíbrio dos adultos obesos. A pesquisa teve como objetivo avaliar o equilíbrio postural e a mobilidade dos indivíduos com obesidade que estão aguardando a realização da Cirurgia Bariátrica. Trata-se de um estudo transversal e descritivo, realizado no Hospital das Clínicas da Universidade Federal de Pernambuco. A amostra foi composta por 97 indivíduos, sendo 81 mulheres, 16 homens, idade 38,39 ± 10,60 anos e índice de massa corporal 47,5 ± 6,9 kg/m2. O teste Timed Up and Go, que avalia a mobilidade, teve como resultado 7,6 ± 1,7 segundos como a média dos maiores tempos gastos para a execução do teste. A respeito da avaliação do equilíbrio dinâmico e da mobilidade, verificou-se que os domínios de ajustes posturais antecipatórios, necessários para prevenir perturbações posturais (mediana 5, IC95% 5-6) e o domínio de movimentação dinâmica, que corresponde ao equilíbrio necessário para a realização da marcha (mediana 8; IC95% 7-9) são os mais prejudicados nos sujeitos com obesidade avaliados. Foram constatadas correlações positiva entre peso e equilíbrio dinâmico. Os achados indicam que o excesso de gordura corporal interfere no equilíbrio dinâmico. cardiovasculares mecânicas biomecânicos obesos Bariátrica Tratase Trata se descritivo Pernambuco 9 8 mulheres 1 homens 3839 38 39 38,3 1060 10 60 10,6 475 47 5 47, 69 6 6, kgm2 kgm kg m2 m kg/m2 Go 76 7 7, 17 1, verificouse verificou antecipatórios mediana IC95 IC 56 5-6 dinâmica 79 7-9 avaliados 383 3 38, 106 10, 4 kg/m IC9 5- 7-

Abstract Obesity is considered a risk factor to health and besides generating metabolic and cardiovascular alterations, it is related to mechanical complications. Since stability may be altered due to anthropometric and biomechanical factors, studies investigating the relationship of excess weight on the mobility and balance of obese adults are still scarce. The research aimed to evaluate the postural balance and mobility of obese individuals who are waiting for bariatric surgery. This is a cross-sectional and descriptive study, conducted at the Hospital das Clínicas of the Universidade Federal de Pernambuco. The sample consisted of 97 individuals, 81 women, 16 men, age 38.39 ± 10.60 years and body mass index 47.5 ± 6.9 kg/m2. The Timed Up and Go test, which evaluates the mobility, resulted in 7.6 ± 1.7 seconds as the average of the longest times spent to perform the test. Regarding the evaluation of dynamic balance and mobility, it was found that the domains of anticipatory postural adjustments, necessary to prevent postural disturbances (median 5, 95%CI 5-6) and the domain of dynamic movement, which corresponds to the balance necessary to walk (median 8, 95%CI 7-9) are the most impaired in the subjects with obesity. Positive correlations were found between weight and dynamic balance. The findings indicate that excess body fat interferes with dynamic balance. alterations complications factors scarce surgery crosssectional cross sectional study Pernambuco 9 8 women 1 men 3839 38 39 38.3 1060 10 60 10.6 475 47 5 47. 69 6 6. kgm2 kgm kg m2 m kg/m2 test 76 7 7. 17 1. adjustments median 95CI CI 95 56 5-6 movement 79 7-9 obesity 383 3 38. 106 10. 4 kg/m 5- 7-

SUMMARY OBJECTIVE: Pathology in any segment of the spine-pelvis-lower extremity may impair the global postural balance, leading to compensatory alterations in other parts. The aim of this study was to compare the pelvic movements of patients suffering from knee osteoarthritis with patients who underwent total knee arthroplasty and healthy controls. METHODS: This study was performed at the Department of Orthopedics and Traumatology Clinic of a Cankiri State Hospital between April 2021 and February 2022. This study included 84 participants. Of them, 31 patients who underwent total knee arthroplasty between 2018 and 2020 years were selected as the total knee arthroplasty group, while 28 patients with knee osteoarthritis were selected as the knee osteoarthritis group. In the control group, there were 25 healthy individuals. Exclusion criteria from the study included any kind of neurological disease, an inability to walk a distance of 100 m unassisted, or a history of surgery to the lower limb. Pelvic movements (i.e., tilt, rotation, and obliquity) and gait parameters (i.e., “gait velocity,” “cadence,” and “stride length”) were assessed using a wireless tri-axial accelerometer. RESULTS: Total knee arthroplasty and control groups had decreased minimum anterior tilt of the pelvis, decreased maximum anterior tilt, and decreased oblique range of the pelvis compared with the knee osteoarthritis group. In comparison with the control group, gait velocity and length of stride during gait were remarkably lower in both knee osteoarthritis and total knee arthroplasty groups. CONCLUSION: In this study, total knee arthroplasty was found to affect pelvic movements. It was thought that total knee arthroplasty changed these variables, probably owing to the frontal and sagittal plane alignment correction through surgery. OBJECTIVE spinepelvislower spine balance parts controls METHODS 202 2022 8 participants them 3 201 group 2 individuals disease 10 unassisted limb i.e., ie i e (i.e. rotation obliquity velocity, cadence, cadence “cadence, length” triaxial tri axial accelerometer RESULTS CONCLUSION variables 20 1 i.e. (i.e “cadence i.e

RESUMO Objetivo Investigar a prevalência de alterações posturais e correlacionar com o peso corporal e o peso das mochilas dos escolares em uma escola no município de São João del-Rei-MG. Métodos O estudo é do tipo original, com delineamento transversal onde foram avaliados 109 escolares, com média de idade de 13 anos, de ambos os sexos. A escala de Nova Iorque foi utilizada para análise de postura, medição do peso corporal, altura, peso da mochila e Índice de Massa Corporal (IMC). Foi utilizado o teste estatístico ANOVA e o teste de correlação de Pearson, considerando o nível de significância de 0,05. Resultados De acordo com os resultados, a média geral dos escores dos problemas posturais foi de 68,7 pontos, com predomínio na região da cabeça, coluna, nos quadris, no tronco, e no abdômen. As regiões dos ombros, pés e pescoço apresentaram médias de escores menores que 7. A média da altura foi de 1,61m, do peso corporal de 56,03kg, do peso das mochilas de 4,49 kg e 21,51 kg/m do IMC. Conclusão Conclui-se que existe uma alta prevalência de alterações posturais entre os escolares avaliados. Sendo que, os segmentos corporais mais comprometidos são, a cabeça, a coluna vertebral, os quadris, o tronco e o abdômen. No entanto, esse achado não foi relacionado ao peso das mochilas ou ao peso corporal dos escolares. Assim, diferentes parâmetros devem ser utilizados para analisar os fatores que podem estar relacionados a tais achados, como alterações ergonômicas, hábitos inadequados, estirão de crescimento, entre outros. Nível de Evidência III, Estudo Transversal Observacional. delReiMG. delReiMG del Rei MG. MG del-Rei-MG original 10 1 anos sexos postura IMC . (IMC) Pearson 005 0 05 0,05 resultados 687 68 7 68, pontos cabeça quadris abdômen ombros 161m m 61m 1,61m 5603kg 56 03kg 56,03kg 449 4 49 4,4 2151 21 51 21,5 kgm Concluise Conclui se são vertebral entanto Assim achados ergonômicas inadequados crescimento outros III Observacional (IMC 00 0,0 6 5 44 4, 215 2 21, 0,

ABSTRACT Objective Investigate the prevalence of postural changes and correlate them with body weight and the weight of schoolchildren’s backpacks in a school in the city of São João del-Rei-MG. Material and Methods The study is an original type, with a cross-sectional design, where 109 schoolchildren of both sexes and mean age of 13 years were evaluated. The New York scale was used for posture analysis, measuring body weight, height, backpack weight, and Body Mass Index (BMI). The ANOVA statistical test and Pearson’s correlation test were used, considering a significance level of 0.05. Results According to the results, the general average of the scores of postural problems was 68.7 points, with a predominance in the head, spine, hips, trunk, and abdomen. The regions of shoulder, feet, and neck presented mean scores below seven. The mean height was 1.61 m, body weight 56.03 kg, backpack weight 4.49 kg and BMI was 21.51 kg/m. Conclusion Postural alterations are highly prevalent among the evaluated students. The most affected body segments are the head, spine, hips, trunk, and abdomen. However, this finding was not related to the weight of the backpacks or the students’ body weight. However, different parameters must be used to analyze the factors that may be related to such findings, such as ergonomic changes, inadequate habits, growth spurt, among others. Evidence Level III,Cross-sectional Observational Study. schoolchildrens s delReiMG. delReiMG del Rei MG. MG del-Rei-MG type crosssectional cross sectional design 10 1 analysis BMI. . (BMI) Pearsons Pearson 005 0 05 0.05 results 687 68 7 68. points head spine hips trunk abdomen shoulder feet seven 161 61 1.6 m 5603 56 03 56.0 449 4 49 4.4 2151 21 51 21.5 kgm kg/m students However findings habits spurt others III,Crosssectional IIICrosssectional III,Cross III Cross Study (BMI 00 0.0 6 16 1. 560 5 56. 44 4. 215 2 21. Crosssectional IIICross 0.

ABSTRACT The analysis of the gait and posture is useful for the study of hereditary ataxias. The clinical test does not offer objective information of alterations of its parameters. Instrumental methods provide quantitative measures to describe progress disorders and posture. The main instrumental methods used are the movement capture videographic, the pressure sensitive gateway system GaitRite and the inertial sensor system APDM Mobility Lab. The most reported alterations in patients with ataxia are decreased cadence; stride length, gait speed, increase in double support of lower limb, length and acceleration of postural sway. The most advantageous method is the system of inertial sensors. The alterations detected with instrumental methods provide valuable information in the early detection of ataxias, their progression and to measure the response to therapeutic interventions.

RESUMEN El análisis de la marcha y la postura es útil para el estudio de las ataxias hereditarias. El examen clínico no ofrece información objetiva de alteraciones de sus parámetros. Los métodos instrumentales proporcionan medidas cuantitativas para describir los trastornos de la marcha y la postura. Los principales métodos instrumentales utilizados fueron los videográficos de captura de movimiento, el sistema de pasarela sensible a presión GaitRite y el sistema de sensores inerciales APDM Mobility Lab. Entre las alteraciones más reportadas en pacientes con ataxia han destacado: la disminución de la cadencia, la longitud del paso, la velocidad de marcha, el aumento del doble soporte de extremidades inferiores, la longitud y aceleración del balanceo postural. El método más ventajoso ha sido el sistema de sensores inerciales. Las alteraciones detectadas con métodos instrumentales aportan información valiosa en la detección temprana de las ataxias, su progresión y para medir la respuesta a intervenciones terapéuticas.

Resumen En este artículo se presenta el término “somatoapraxia” para referirse a la dificultad en el manejo corporal y ajustes posturales en la realización de acciones, debido a alteración en el procesamiento somatosensorial y propioceptivo como consecuencia de daño cerebral adquierido. Además, se plantea la somatoapraxia como un factor primario de las apraxia y su aplicabilidad en un modelo de rehabilitación neuropsicológica. Se consideran las alteraciones somatosensoriales y propioceptivas como subyacentes a varios tipos de apraxia y su manifestación en diferentes patologías neurológicas. El reconocimiento de la somatoapraxia como componente clínico de la apraxia y la afección a la vida de los pacientes, permite mejorar los programas de rehabilitación existentes.

Abstract This article proposes the term Somatodyspraxia to refer to the difficulties in body management and postural adjustments for performing actions, due to alterations in somatosensory and proprioceptive processing, as a consequence of acquired brain injury. In addition, we propose Somatoapraxia as a primary factor for apraxia and describe its applicability for a Neuropsychological Rehabilitation Model for apraxia. The explanatory models of apraxia, the somatosensory and proprioceptive alterations underlying various types of apraxia, and their manifestation in different neurological conditions, are taken into consideration. Recognizing Somatodyspraxia as a clinical component of patient’s life allows its integration for the improvement of current existing rehabilitation programs.

Abstract Aim: The present study aimed to investigate the effects of different backpack loads on the walking gait kinematics and ratings of perceived exertion (RPE) in Brazilian scholars. Methods: The sample was composed of 25 male children and adolescents, from 10 to 14 years. The mean body mass and height were 45.3 kg ± 10.6 kg and 1.51 m ± 0.08 m, respectively. For the walking gait assessment, a tridimensional analysis system was used. In the backpack conditions, loads of 5%, 10%, 15%, and 20% were applied according to the body weight of everyone. Kinematic variables and angular amplitudes of head, shoulders, thorax, pelvis, and knees in the sagittal plane were collected. The OMNI scale was used to assess the RPE. Results: The loads of 5%, 10%, 15%, and 20% promoted postural adjustments and alterations in the walking gait, in which the RPE presented a correlation with those alterations. The step in the left cycle altered from the baseline in the 5% (p = 0.006). The stride length altered from baseline in the 5% (p = 0.030) and 10% (p < 0.001) load conditions. The single support time was different from baseline in all conditions (p = 0.003; p = 0.012; p = 0.005; p = 0.006). The walking gait cadence was different in the comparison between baseline in the 5% (p = 0.003). Thorax amplitude altered in the 10% (p = 0.023), 15% (p = 0.033) and 20% (p = 0.005) load conditions in the left cycle. Conclusion: We concluded that the posture, RPE, and the gait kinematic altered according to the increase in the backpack load.