Abstract Background Acknowledging the relationship between postural control and muscle strength in lower limbs is important to find persons with high fall risk and to design fall prevention exercise programs. Objective To investigate the connection between knee muscle strength, semi-static postural balance, and functional mobility in irregularly active older women. Methods One hundred and ten older women aged 60 to 85 years underwent a semi-static postural balance test in a force and functional mobility measured by Timed Up & Go (TUG) with and without Cognitive Tasks (CT). Muscle strength of the knee was assessed by isokinetic dynamometry at 60°/s. Results A negative correlation between the functional mobility (TUG with and without CT) and the muscular strength of the knee was observed. Regarding semi-static balance, there was a low negative correlation with peak torque corrected for body weight of the extensors with the following variables with eyes open: Mean Velocity Dominant limb (D) (r = -0.19; p = 0.03); and anteroposterior range Non-Dominant limb (ND) (r = -0.19; p = 0.04); with eyes closed: mediolateral range ND limb (r = -0.21; p = 0.02) and Mean Velocity ND limb (r = -0.18; p = 0.05). Conclusions This study found that better functional mobility was associated with greater muscle strength in the knee in elderly women. There were weak negative correlations between knee extensor strength and some measures of semi-static postural balance, suggesting that different motor control actions are required to maintain semi-static balance and mobility. In the case of semi-static balance, a lower level of muscle response is required than in functional mobility. programs semistatic semi static 6 8 TUG CT. CT . (CT) 60s s 60°/s observed open D (D r 0.19 019 0 19 -0.19 0.03 003 03 0.03) NonDominant Non (ND 0.04 004 04 0.04) closed 0.21 021 21 -0.21 0.02 002 02 0.18 018 18 -0.18 0.05. 005 0.05 05 0.05) (CT 0.1 01 1 -0.1 0.0 00 0.2 2 -0.2 0. -0. -0 -

Abstract Introduction An accurate assessment of balance problems is critical for decreasing the risk of falling in patients with Parkinson's Disease (PD). Reliable diagnostic tools such as Computerized Dynamic Posturography (CDP) are not feasible for the clinical setting. Therefore, the present study's aim was to assess the correlation between the clinical Balance Evaluation Systems Test (BESTest) and CDP. Methods 20 male older adults with Parkinson's Disease (PD) were included in this study. Participants first executed the Sit-To-Stand (STS), Step/Quick turn (SQT), and Step Up and Over (SUO) tests on a Balance Master® force platform, followed by a clinical balance evaluation using the BESTest. Results Four outcomes of the CDP were negatively correlated with one or more BESTest domains or total BESTest score: STS sway velocity was negatively correlated with the anticipatory postural adjustment (p = 0.02) and sensory orientation (p = 0.01) domains. SQT turn time was negatively correlated with biomechanical restriction (for turns to the left, p = 0.01, and right, p = 0.03, respectively), postural response (p = 0.01, p = 0.01), dynamic balance during gait (p = 0.007, p = 0.001), and total score (p = 0.02, p = 0.01). Step over time to the right in SUP was negatively correlated with the limits of the stability domain (p = 0.002) and total BESTest score (p = 0.020). SUO impact index was negatively correlated with the anticipatory postural adjustment domain (p = 0.01). Conclusion This study shows that several BESTest domains are significantly correlated with CDP outcomes, demonstrating that the BESTest can be used as a more clinically feasible alternative for computerized posturography, without loss of information. Parkinsons Parkinson s PD. PD . (CDP setting Therefore studys (BESTest 2 (PD SitToStand Sit To Stand STS, , (STS) StepQuick Quick SQT, (SQT) (SUO Master platform 0.02 002 0 02 0.01 001 01 left 003 03 0.03 respectively, respectively respectively) 0007 007 0.007 0.001, 0001 0.001 0.001) 0.01. 0.002 0002 0.020. 0020 0.020 020 0.020) posturography information (STS (SQT 0.0 00 000 0.00 0.

Abstract Context In the elderly, weak lower limb muscles impair functional tasks' performance. Objective To evaluate the healthy elderly's ankle dorsiflexion and plantarflexion maximum torque and its variability in two sets of 5 RM isokinetics evaluation. Method 50 women (68.0 ± 4.6 years old) and 50 men (72.7 ± 8.5 years old) did two sets of ankle plantar flexor and dorsiflexor isokinetic tests at 30°/s. Peak torque, total work, and coefficient of variation were analyzed. Results Men did the strongest plantarflexion torque (p < 0.05) and dorsiflexion torque (p < 0.05); their highest peak torque occurred at set 2 (p < 0.05), while the largest plantarflexion torque variability (p < 0.05), dorsiflexion torque variability (p < 0.05), and the largest plantarflexion torque variability occurred at set 1 (p < 0.05). Men did the highest plantarflexion and dorsiflexion total work (p < 0.05) at set 2 (p < 0.05). Conclusion Older men are stronger than older women. The torque variability, in men, was higher during the first set, suggesting an adaptation to the isokinetics evaluation. Clinicians and researchers should consider that different muscles might need different numbers of sets and trials to measure their maximal muscle strength.

Abstract Context Aging causes a progressive worsening in postural balance, affecting functional independence and increasing the risk of falls. Objective The aim of the study was to evaluate the effect of aging on the static balance in women from 50-years to 89-years of age. Design This was a cross-sectional study, with 400 irregularly active women were evaluated and grouped by age: Group 6thdecade (age 50 to 59) ‒ 58 participants; Group 7thdecade (age 60 to 69) ‒ 214 participants; Group 8thdecade (age 70 to 79) ‒ 92 participants; Group 9thdecade (age 80 to 89) ‒ 36 participants. Postural balance was evaluated using a portable force platform in a standard standing position, with Eyes Open (EO) and Eyes Closed (EC). Results In the two measurement conditions, the elderly women in Group 9thdecade presented mediolateral displacement and range, and mean velocity greater than the women's values in Groups 6thand 7thdecade. In the EO e EC situation, the displacement was higher in the elderly Group 9thdecade compared to younger groups. Group 8thhas a mean velocity greater than Group 6thdecade in the EO situation. Conclusions Posturography showed a decline in postural balance with advancing age, suggesting that the 9thdecade of life is a borderline age to this detriment due to an increase in postural instability.

OBJECTIVES: To evaluate the clinical characteristics, ground reaction force (GRF), and function of the plantar muscles and dorsiflexors of the ankle in runners with and without Achilles tendinopathy (AT) and in non-runners. METHODS: Seventy-two participants (42 men, 30 women; mean age: 37.3±9.9 years) were enrolled in this cross-sectional study and divided into three groups: AT group (ATG, n=24), healthy runners’ group (HRG, n=24), and non-runners’ group (NRG, n=24). Both ankles were evaluated in each group. The American Orthopedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Scale was used for clinical and functional evaluation. GRF was evaluated using force plates and muscle strength was evaluated using an isokinetic dynamometer. RESULTS: The AOFAS scores were lower in the ATG. The strike impulse was higher in the ATG than in the HRG and NRG. However, GRF was similar among the groups. The ATG exhibited lower total work at 120°/s speed than the HRG. The peak torque in concentric dorsiflexion was lower in the NRG than in the ATG and HRG. The peak torque and total work in concentric plantar flexion were lower in the NRG than in the ATG. The peak torque and total work in eccentric plantar flexion were lower in the NRG than in the ATG and HRG. CONCLUSION: Runners with AT showed higher strike impulse, lower muscle strength of the plantar flexors, and higher clinical and functional damage.

RESUMO Este estudo tem como objetivo analisar e resumir as diferenças biomecânicas (cinéticas, cinemáticas e neuromusculares) da corrida com calçado e descalço através de uma revisão de literatura. Foram realizadas buscas por artigos completos publicados entre 2013 e novembro de 2018 nos bancos de dados Web of Science, PubMed, Scopus e SPORTDiscus. Os descritores usados foram Biomechanics, Kinetics, Kinematics, Electromyography, “Surface Electromyography”; e Unshod, Barefoot, Barefeet e Running. A busca resultou em 687 artigos, e depois da exclusão das duplicatas e seleção através do título, do resumo e do texto completo, 40 artigos foram incluídos na revisão. Os resultados evidenciam que existem diferenças importantes na biomecânica da corrida entre as condições calçado e descalço. De maneira geral, os estudos indicam que, na corrida descalço: (a) os indivíduos apresentam padrão de pisada com o antepé ou mesopé, enquanto na corrida com calçado, o padrão típico é com o retropé; (b) observa-se maior cadência e menor comprimento da passada; e (c) ocorre maior flexão de joelho, menor pico de força vertical de reação do solo e maior ativação da parte medial do gastrocnêmio. Ainda, na condição descalço, os corredores fazem o contato com o solo com maior flexão plantar, possivelmente buscando uma estratégia de atenuação de impacto durante a pisada sem calçado. Essas diferenças, assim como a individualidade dos praticantes, devem ser consideradas na prescrição da corrida descalço, visando minimizar a ocorrência de lesões decorrentes da prática. Nível de evidência II; Estudo de Revisão.

ABSTRACT This study aims to analyze and summarize the biomechanical (kinematics, kinetics and neuromuscular) differences between shod and barefoot running, through a literature review. Searches were conducted for complete articles published between 2013 and November 2018 in the Web of Science, PubMed, Scopus and SPORTdiscus databases. The search terms used were Biomechanics, Kinetics, Kinematics, Electromyography, “Surface Electromyography”; and Unshod, Barefoot, Barefeet and Running. The search resulted in 687 articles; after excluding duplicates and selecting by title, abstract and full text, 40 articles were included in the review. The results show that there are important differences in the biomechanics of running when shod or barefoot. In general, studies indicate that in barefoot running: a) individuals present forefoot or midfoot foot strike patterns, while in shod running the typical pattern is the rearfoot strike; (b) greater cadence and shorter stride length are observed; and (c) there is greater knee flexion, lower peak vertical ground reaction force and greater activation of the medial gastrocnemius. In addition, barefoot runners contact the ground with greater plantar flexion, possibly as a strategy to reduce impact when stepping without footwear. These differences, as well as runners’ individual characteristics, should be considered in the prescription of the barefoot running, in order to minimize injuries resulting from the practice. Level of Evidence II; Review.

RESUMEN Este estudio tiene como objetivo analizar y resumir las diferencias biomecánicas (cinéticas, cinemáticas y neuromusculares) de la carrera con calzado y descalzo a través de una revisión de literatura. Fueron realizadas búsquedas de artículos completos publicados entre 2013 y noviembre de 2018 en los bancos de datos Web of Science, PubMed, Scopus y SPORTDiscus. Los descriptores utilizados fueron Biomechanics, Kinetics, Kinematics, Electromyography, “Surface Electromyography”; y Unshod, Barefoot, Barefeet; y Running. La búsqueda resultó en 687 artículos, y después de la exclusión de los duplicados y selección a través del título, del resumen y del texto completo, 40 artículos fueron incluidos en la revisión. Los resultados evidencian que existen diferencias importantes en la biomecánica de la carrera entre las condiciones calzado y descalzo. De manera general, los estudios indican que, en la carrera descalzo: (a) los individuos presentan padrón de pisada con el antepié o mesopié, mientras que en la carrera con calzados, el padrón típico es con el retropié; (b) se observa mayor cadencia y menor longitud de la pasada; y (c) ocurre mayor flexión de la rodilla, menor pico de fuerza vertical de reacción del suelo y mayor activación de la parte medial del gastrocnemio. Además, en la condición descalzo, los corredores hacen el contacto con el suelo con mayor flexión plantar, posiblemente buscando una estrategia de atenuación de impacto durante la pisada sin calzado. Estas diferencias, así como la individualidad de los practicantes, deben ser consideradas en la prescripción de la carrera descalzo, buscando minimizar la ocurrencia de lesiones provenientes de la práctica. Nivel de Evidencia II; Estudio de Revisión.

Resumo Apesar do aumento no número de competições Ironman em todo o mundo e milhares de atletas se juntarem à experiência Ironman, apenas alguns estudos foram publicados sobre os efeitos dessa competição no controle postural. Este estudo tem como objetivo investigar a capacidade de manter uma postura estática em três posições diferentes antes e depois de uma competição de Ironman e o comportamento do nível de glicose no sangue. Quarenta e nove voluntários foram submetidos à avaliação do equilíbrio usando uma plataforma de força, VSRTM Sport. A área do centro de gravidade (ACOG) foi avaliada pré e pós-competição nas posturas bipodal, unipodal e tandem. Os níveis de glicose também foram avaliados simultaneamente. Os achados do ACOG mostraram um aumento significativo pós-competição nas três posturas avaliadas, sem interação significativa entre as posturas. O teste de glicose mostrou aumento nos níveis glicêmicos pós-competição. Os resultados mostraram decréscimo no controle postural, sugerindo que a estimulação prolongada ao exercício poderia levar a um distúrbio no controle postural.

Abstract Despite the increase in the number of Ironman competitions worldwide, thousands of athletes have been joining Ironman experience but only a few studies have been published on the effects of this competition on postural control. This study aims to investigate the ability to maintain a static posture in three different positions before and after an Ironman competition and the blood glucose level behavior. Forty-nine volunteers underwent balance evaluation using the force plate VSRTM Sport. The area of the center of gravity (ACOG) was assessed pre- and post-competition in the bipodal, unipodal, and tandem postures. Glucose levels were also assessed concurrently. The ACOG findings showed a significant post-competition increase in the three postures assessed, with no significant interaction between the postures. The glucose test showed an increase in the post-competition glycemic levels. The findings showed reduced postural control, suggesting that prolonged exercise stimulation could lead to a disturbance in postural control.

RESUMO Objetivo: Comparar a função do membro superior e a qualidade de vida entre crianças com paralisia obstétrica do plexo braquial e aquelas sem paralisia do plexo braquial (crianças usuais). Métodos: Foram avaliadas 24 crianças com paralisia obstétrica do plexo braquial e 24 crianças usuais, ambos os grupos com 10±3 anos. A função do membro superior foi avaliada pela Escala Mallet Modificada e Active Movement Scale, já a qualidade de vida foi analisada por meio das escalas Pediatric Outcome Data Collection Instrument e Child Health Questionnaire. Foram realizados testes U de Mann-Whitney para investigar diferenças entre os grupos nas escalas. Resultados: Crianças com paralisia obstétrica do plexo braquial apresentaram menor função do membro superior quando comparadas às crianças usuais, em ambas as escalas utilizadas. Essas crianças também apresentaram menores pontuações para a maioria dos domínios do Pediatric Outcome Data Collection, exceto para conforto/dor. Além disso, apresentaram escores inferiores nos seguintes domínios do Child Health Questionnaire: função física, dor, comportamento, saúde mental, percepção da saúde em geral, impacto emocional nos pais e pontuação psicossocial resumida. Conclusões: A paralisia obstétrica do plexo braquial tem uma influência negativa na função do membro superior e na qualidade de vida, principalmente em relação à saúde geral, mobilidade básica, funções física e psicossocial, felicidade, dor, comportamento, saúde mental, funcionalidade do membro superior e impacto emocional nos pais.

ABSTRACT Objective: To compare the upper limb function and quality of life between children with neonatal brachial plexus palsy and controls with unaffected brachial plexus (typical children). Methods: Twenty-four children with neonatal brachial plexus palsy and 24 typical ones were evaluated, both groups with 10±3 years of age. The upper limb function was assessed by the Modified Mallet Scale and the Active Movement Scale, whereas quality of life was analyzed by the Pediatric Outcome Data Collection Instrument and the Child Health Questionnaire. Mann-Whitney U tests investigated the differences between groups in such scales. Results: Children with neonatal brachial plexus palsy presented lower limb function compared to typical children in both scales. These children also presented lower scores for most of the Pediatric Outcome Data Collection Instrument domains, except for comfort/pain. In addition, they had lower scores in the following domains of the Child Health Questionnaire: physical functioning, pain, behavior, mental health, overall health perception, emotional impact on parents, and psychosocial summarized score. Conclusions: Neonatal brachial plexus palsy has a negative influence on upper limb function and quality of life, mainly considering overall health, basic mobility, physical and psychosocial functions, happiness, pain, behavior, mental health, upper limb function, and emotional impact on their parents.

Resumo O entendimento da fadiga durante a competição de Tiro com Arco pode auxiliar na otimização da rotina de treinamento de atletas em diferentes níveis competitivos. Este estudo investigou o efeito do nível de experiência do atleta sobre as respostas fisiológicas, durante competição simulada de Tiro com Arco para um atleta de elite (EA) e um arqueiro iniciante (NA). Esforço percebido, concentração de lactato e glicose sanguínea, força de preensão manual e eletromiografia foram registrados no início, após cada série e, 30-min após a simulação. O EA apresentou maior força de preensão manual para ambos braços, valor de média RMS constantemente mais baixo (Baseline 0,279V e 12ª série 0,221V, -20,7%), e valor de MF estável no decorrer da competição (Baseline 146Hz a 12a série 140Hz). O NA demonstrou menor força de preensão manual, aumento na RMS após a 6a série até o final da competição (Baseline 0,387V, 6a 0,576V, and 12a série 0,720V, +46,2%) e pequena diminuição na MF da 6ª até o final da 12ª série (2a série 122Hz, 4a série 127Hz, 6a série 112Hz e 12a série 117Hz, - 4,1%). Assim, todos os marcadores relacionados a fadiga apresentaram resposta discreta na simulação de competição de Tiro com Arco, com maior magnitude no NA, em comparação com EA. Este estudo apresentou as demandas fisiológicas da competição simulada de Tiro com Arco, no formato oficial, permitindo que treinadores e cientistas do esporte possam tomar decisões com maior confiança sobre estratégias de competição e treinamento.

Abstract The understanding of fatigue development during Archery competition would guide sports scientists, coaches and athletes on how to optimize the training routines of athletes from different competitive levels. This study investigated the effect of expertise level on physiological responses, during simulated archery competition (double-round 70m, 12 series, 6 arrows for an elite Brazilian Archer (EA) and a Novice Archer (NA). Ratings of perceived exertion, blood lactate and glucose, handgrip strength and electromyography were registered at the beginning, after each set from the 2nd to the 12tharrow and, 30-min after the competition simulation. The EA showed a greater handgrip strength for both arms, a constant lower mean RMS value (Baseline 0.279V and 12th set 0.221V, -20.7%), and a stable MF value throughout the competition (Baseline 146Hz to 12th set 140Hz). The NA showed a smaller handgrip strength, an increase in RMS after the 6th set towards the end of the competition (Baseline 0.387V, 6th 0.576V, and 12th set 0.720V, +46.2%) and a minor decrease in MF from the 6th to the end of 12th set (2nd set 122Hz, 4th set 127Hz, 6th set 112Hz and 12th set 117Hz, - 4.1%). In summary, all the fatigue-related markers showed a mild response to the Archery competition simulation, although a greater magnitude was observed in the NA, compared to the EA. This study reported the physiologic demands of an Archery simulated competition, in an official format, allowing coaches and sport scientists to draw more confident decisions on competition strategy and training design.

RESUMO Comparamos o efeito do treinamento de marcha em esteira versus piscina no equilíbrio e na marcha em 12 sobreviventes crônicos de AVC isquêmico separados aleatoriamente nos grupos piscina ou esteira. A escala de Berg (EEB) e timed up and go test (TUG) foram aplicados antes e após as intervenções. A EMG de superfície dos músculos do lado parético e não parético foi registrada na caminhada em esteira. Três janelas de 100 ms foram extraídas da EMG relacionada às fases da marcha: aceitação de peso; propulsão; e pré-contato do pé. Para cada fase, calculou-se o RMS do sinal EMG. Os participantes treinaram 9 semanas (3 vezes/semana, 40 minutos/sessão). O grupo piscina fez marcha na água com cinto de natação. O grupo esteira fez treinamento de marcha na na velocidade máxima confortável. A Manova comparou o efeito do treinamento, grupo, lado, músculos e fase da marcha na EMG. A Anova testou o efeito do treinamento, lado do grupo e fase da marcha nas variáveis BBS, TUG e EMG. Os grupos piscina e esteira aumentaram o equilíbrio e a agilidade. O maior EMG RMS ocorreu no lado parético, no grupo esteira e após o treinamento. Os músculos: tibial anterior, gastrocnêmio lateral, vasto lateral e bíceps femoral apresentaram o maior RMS para o lado não parético; enquanto para os músculos reto femoral e semitendíneo, o lado parético apresentou o maior RMS. Assim, os dois tipos de exercício levaram a adaptações funcionais semelhantes com diferentes ativações musculares durante a caminhada.

ABSTRACT We compared the effect of gait training on treadmill versus deep water on balance and gait in 12 ischemic stroke chronic survivors randomly sorted to the Pool or Treadmill Groups. Berg Scale (BBS) and timed up and go test (TUG) were applied before and after the interventions. Just one person applied all tests and she was blinded for the aims of the study. Surface EMG of the paretic and non-paretic (NP) side muscles were recorded during walking on a treadmill. Three 100-ms epochs were extracted from the EMG related to gait phases: weight acceptance; propulsion; and pre-strike. For each epoch, we calculated the RMS of the EMG signal. Participants did gait training for 9 weeks (3 times/week, 40 minutes/session). The Pool group did the deep-water walking with a swimming belt. The Treadmill group walked on the treadmill at the maximum speed they could stand. The Manova group compared the effect of training, group, side, muscles, and gait phase into the EMG. Anova was used to test the effect of training, group side, and gait phase into BBS, TUG and EMG variables. Pool and Treadmill had increased balance and agility. The highest EMG RMS occurred at the paretic side, for the Treadmill and after training. The mm. tibialis anterior, gastrocnemius lateralis, vastus lateralis, and biceps femoris presented the highest RMS for the NP side; while for mm. rectus femoris and semitendinosus, the paretic side presented the highest RMS. Thus, the both types of exercise lead to similar functional adaptations with different muscular activations during walking.

RESUMEN Se comparó el efecto del entrenamiento de la marcha en cinta de correr y en piscina en el equilibrio y la marcha de 12 sobrevivientes crónicos de accidente cerebrovascular isquémico, quienes fueron clasificados aleatoriamente en los grupos piscina o cinta de correr. Se aplicaron la Escala de Equilibrio de Berg (BBS) y la Timed up and go test (TUG) antes y después de las intervenciones. Solo una persona aplicó todas las pruebas con evaluación ciega para los objetivos del estudio. Se registró la EMG de superficie de los músculos laterales paréticos y no paréticos durante la caminata en la cinta. Se extrajeron tres momentos de 100 ms de la EMG relacionadas con las etapas de la marcha: aceptación de peso; propulsión; y precontacto del pie. Para cada momento, se calculó el RMS de la señal EMG. Los participantes realizaron entrenamientos de marcha durante 9 semanas (3 veces/semana, 40 minutos/sesión). El grupo piscina caminó con un cinturón de natación. El grupo cinta de correr caminó en la cinta a la velocidad máxima confortable. Utilizando la Manova se comparó el efecto del entrenamiento, el grupo, los músculos laterales y la fase de la marcha en la EMG. Con la ANOVA se probó el efecto del entrenamiento, el lado grupal y la fase de marcha en las variables BBS, TUG y EMG. El equilibrio y la agilidad aumentaron en ambos grupos. El EMG RMS más alto ocurrió en el lado parético del grupo cinta de correr y después del entrenamiento. Los músculos tibial anterior, gastrocnemio lateral, vasto lateral y bíceps femoral presentaron el RMS más alto en el lado no parético; mientras que en los músculos recto femoral y semitendinoso, el lado parético presentó el RMS más alto. Por lo tanto, los dos tipos de ejercicio conducen a adaptaciones funcionales similares con diferentes activaciones musculares durante la marcha.

Abstract Aims: The purpose of this study was to test an experimental fatigue protocol for the knee joint extensor muscles performed on an isokinetic dynamometer. Method: SPIRIT recommendations were applied. Participants were 40 healthy, young men and women. Protocol: The pre-fatigue quadriceps femoris peak torque during concentric maximum voluntary contractions (MVC) at 60º/s was measured. During the first protocol part, the task was to do MVC at 60°/s until a sequence of five concentric MVC was below 40% of its initial value. For the second part, intermittent quadriceps femoris muscle and hamstrings maximum voluntary isometric contractions for 30 s (ratio 2/1 seconds). Thirty seconds after the isometric MVC (post-fatigue), they did three concentric MVC. Then, after 5 minutes of absolute rest, they did two concentric MVC. Men and women showed a lower peak torque due to this protocol (p < 0.001). Conclusion: This protocol was effective for fatigue men and women’s quadriceps femoris muscle.

RESUMO O objetivo desta pesquisa foi mensurar de forma objetiva a propriocepção, em diferentes situações (com e sem o auxílio da visão, com e sem tarefa cognitiva concomitante e de forma ativa ou passiva), em indivíduos idosos e adultos. Participaram do estudo dez adultos saudáveis e dez idosos saudáveis. Foram estudados os efeitos de diferentes restrições no desempenho do movimento por meio dos erros absoluto (precisão) e relativo (consistência). A mensuração do senso de posicionamento do tornozelo foi realizada com o dinamômetro isocinético Biodex Sistem 3. A análise de variância de quatro fatores e o teste post hoc de Tukey foram utilizados para analisar os parâmetros. Os resultados mostraram que o fator sujeito interfere no erro absoluto, pois os grupos apresentaram diferença significativa: os idosos erram mais quando comparados com os adultos. Os demais fatores (visão, tarefa cognitiva e tipo de movimento) não apresentaram diferença significativa. No erro relativo os resultados mostraram que a tarefa cognitiva concomitante ao movimento foi capaz de produzir diferença significante; entretanto os demais fatores (indivíduos, visão e tipo de movimentação) não foram capazes de produzir uma diferença significativa. A idade afeta a precisão do sentido proprioceptivo, independentemente da situação. Não houve diferença entre a realização do movimento com e sem o auxílio da visão, e a dupla tarefa (motora associada à cognitiva) afeta a consistência do movimento.

ABSTRACT The objective of this research was to measure objectively the proprioception in different situations (with and without the aid of vision, with or without a concomitant cognitive task, and actively and passively), in elder and adult individuals. Ten healthy adults and ten healthy seniors participated in the study. The effects of different restrictions were studied in the development of movement through absolute (accuracy) and relative (consistency) errors. The sense of ankle positioning was measured with a Biodex System 3isokinetic dynamometer. Four-factor analysis of variance and the Tukey post hoc test were used to analyze the parameters. The results showed that the subject factor interferes in the absolute error, since the groups showed significant difference: the elderly make more mistakes when compared with adults. The other factors (vision, cognitive task and type of movement) did not show significant difference. In the relative error, results showed that the cognitive task concomitant to movement was capable of producing significant difference; however, the other factors (individuals, vision and type of movement) were not. Age affects the accuracy of the proprioceptive sense, regardless of the situation. There was no difference between performing the movement with and without the aid of vision, and the double task (motor associated with cognitive) affects the consistency of the movement.

RESUMEN En este estudio se propone medir objetivamente la propiocepción en situaciones diferentes (con y sin la ayuda de la visión, con y sin la tarea cognitiva concomitante y de forma activa o pasiva), en adultos y adultos mayores. Del estudio han participado diez adultos sanos y diez adultos mayores sanos. Se analizaron los efectos de diversas restricciones en el funcionamiento del movimiento por medio de los errores absoluto (precisión) y relativo (consistencia). La medición del sentido de posicionamiento del tobillo se llevó a cabo por medio del dinamómetro isocinético Biodex System 3. Se utilizaron el análisis de varianza de cuatro factores y la prueba posthoc de Tukey, para analizar los parámetros. Los resultados demostraron que el factor sujeto interfiere en el error absoluto, ya que los grupos presentaron una diferencia significativa: los adultos mayores cometen más errores que los adultos. Los otros factores (visión, tarea cognitiva y tipo de movimiento) no demostraron diferencias significativas. En el error relativo, los resultados desvelan que la tarea cognitiva y el movimiento fueron capaces de producir una diferencia estadísticamente significativa; sin embargo, otros factores (personas, visión y tipo de movimiento) no fueron capaces de producirla. La edad afecta a la exactitud del sentido propioceptivo, independientemente de la situación. No hubo diferencias entre el rendimiento del movimiento con y sin la ayuda de la visión, y la doble tarea -motora relacionada con la cognitiva- impacta en la consistencia del movimiento.

RESUMO As mudanças morfológicas, biomecânicas e funcionais nos pés podem aumentar o risco de queda nos idosos. Os idosos institucionalizados apresentam menor mobilidade e maior risco de queda. O objetivo deste trabalho é verificar as relações das características dos pés com a mobilidade e quedas de idosos institucionalizados e ativos da comunidade. Participaram deste estudo 15 idosos institucionalizados e 15 idosos ativos da comunidade, que foram avaliados quanto à incidência de quedas e por meio do Timed Up and Go Test; presença de hálux valgo e pico de força muscular de flexores do hálux e dos artelhos pela plataforma de pressão. utilizou-se a análise de variância para comparar os grupos. Como resultado, os idosos comunitários apresentaram maior força muscular de flexores dos artelhos que os idosos institucionalizados (p<0,05) e melhor mobilidade funcional. Observou-se risco de queda nos idosos institucionalizados. O hálux valgo grau leve foi a deformidade mais comum. O teste de Pearson não mostrou correlação entre as variáveis analisadas e a incidência de quedas. Conclui-se que a força muscular de flexores dos artelhos é maior nos idosos comunitários, assim como a mobilidade funcional, quando comparados com idosos institucionalizados.

ABSTRACT Morphological, biomechanical and functional changes in the feet may increase the risk of fall in older adults. Institutionalized older adults have less mobility and greater risk of falling. The aim of this study is to check the relationship of the feet’s characteristics with the mobility and falls of institutionalized or active community-dwelling older adults. A total of 15 institutionalized and 15 community-dwelling older adults participated in this study. They were assessed considering the incidence of falls and through the Timed Up and Go Test; presence of hallux valgus; and strength peak of the muscles of the hallux and toes measured by a pressure platform. The variance analysis was used to compare the groups. As a result, the community-dwelling older adults showed greater muscle strength of the toe flexor muscles than institutionalized older adults (p<0.05) and better functional mobility. We observed the risk of fall in institutionalized older adults. Hallux valgus of mild degree was the most common deformity. The Pearson’s correlation coefficient showed no correlation between the analyzed variables and incidence of falls. We concluded that the strength of toe flexor muscles is greater in community-dwelling older adults, as well as the functional mobility, when compared with institutionalized older adults.

RESUMEN Las alteraciones morfológicas, biomecánicas y funcionales en los pies pueden aumentar el riesgo de caída en las personas mayores. Las que están institucionalizadas presentan menor movilidad y mayor riesgo de caída. El propósito de esta investigación es comprobar la relación entre las características de los pies con la movilidad y la caída de personas mayores institucionalizadas y activas en la comunidad. Del estudio, participaron 15 personas mayores institucionalizadas y 15 personas mayores activas en la comunidad, de las cuales se evaluaron la incidencia de caídas mediante el Timed Up and Go Test; la presencia de Hallux valgus y el punto máximo de fuerza muscular de los flexores del Hallux y de los dedos del pie mediante la plataforma de presión. Se utilizó el análisis de varianza para comparar los grupos. Los resultados demuestran que las personas mayores comunitarias presentaron una fuerza muscular de los flexores de los dedos del pie mayor que las institucionalizadas (p<0,05) y también una mejor movilidad funcional. En las personas mayores institucionalizadas se observó riesgo de caída. El Hallux valgus con deformidad leve fue la más común. El test de Pearson no demostró correlación entre las variables evaluadas y la incidencia de caídas. Se concluye que la fuerza muscular de los flexores de los dedos del pie es mayor en las personas mayores comunitarias, así como la movilidad funcional, en comparación a las institucionalizadas.

Abstract AIMS (Stroke patients often present sensory-motor alterations and less aerobic capacity. Joint position sense, which is crucial for balance and gait control, is also affected in stroke patients). To compare the effect of two exercise training protocols (walking in deep water and on a treadmill) on the knee position sense of stroke patients. METHODS This study was designed as a randomized controlled clinical trial. Twelve adults, who suffered a stroke at least one year prior to the start of the study, were randomly assigned to one of two groups: 1) pool group submitted to aerobic deep water walking training; and 2) the treadmill group which was submitted to aerobic walk on a treadmill. Measurements: The position sense, absolute error and variable error, of the knee joint was evaluated prior to and after nine weeks of aerobic training. RESULTS The pool group presented smaller absolute (13.9o versus 6.1o; p < 0.05) and variable (9.2o versus 3.9o; p < 0.05) errors after nine-weeks gait training than the treadmill group. CONCLUSIONS Nine-week aerobic exercise intervention in aquatic environment improved precision in the position sense of the knee joint of stroke patients, suggesting a possible application in a rehabilitation program.

O objetivo foi estimar a carga da doença para as amputações de membros inferiores atribuíveis ao diabetes mellitus no Estado de Santa Catarina, Brasil, no período de 2008 a 2013. Realizou-se um estudo epidemiológico descritivo, utilizando-se o cálculo de anos de vida perdidos ajustados por incapacidade (DALY - disability-adjusted life years). A carga da doença foi alta, mais de 8 mil DALY, distribuídos entre homens e mulheres. A incapacidade respondeu por 93% do DALY e a mortalidade por 7,5%. A carga dos homens foi 5.580,6 DALY, praticamente o dobro das mulheres (2.894,8), sendo que a participação do componente anos de vida saudável perdidos em virtude de incapacidade (YLD - years lost due to disability) dos homens impulsionou esta taxa para 67,6% do total do DALY. Os homens vivem mais tempo com a amputação, por isto perdem mais anos de vida sadia (65,8%), e a mortalidade é maior entre as mulheres (61%). As distribuições das taxas de DALY no estado não mostraram distribuição homogênea. A intensificação de avaliação, planejamento e desenvolvimento de estratégias custo-efetivas para a prevenção e educação em saúde para o pé diabético deve ser considera a partir da maior vulnerabilidade masculina.

The objective was to estimate the burden of disease from lower limb amputations attributable to diabetes mellitus in Santa Catarina State, Brazil, from 2008 to 2013. A descriptive epidemiological study was performed by calculating disability-adjusted life years (DALY). Burden of disease was high, more than 8,000 DALY in men and women. Disability accounted for 93% of DALY and mortality for 7.5%. The burden in men was 5,580.6 DALY, almost double that in women (2,894.8), and the share of the years lost due to disability (YLD) component in men pushed this rate to 67.6% of total DALY. Men live longer following amputation, so they lose more years of healthy life (65.8%), while mortality is higher in women (61%). DALY rates were not distributed homogeneously across the state. The intensification of evaluation, planning, and development of cost-effective strategies for prevention and health education for diabetic foot should be oriented according to higher male vulnerability.

El objetivo fue estimar la carga de enfermedad para las amputaciones de miembros inferiores, atribuibles a la diabetes mellitus en el Estado de Santa Catarina, Brasil, durante el período de 2008 a 2013. Se realizó un estudio epidemiológico descriptivo, utilizándose el cálculo de años de vida ajustados por discapacidad (DALY - disability-adjusted life years). La carga de la enfermedad fue alta, más de 8 mil DALY distribuidos entre hombres y mujeres. La incapacidad supuso un 93% del DALY y la mortalidad un 7,5%. La carga de los hombres fue 5.580,6 DALY, prácticamente el doble de las mujeres (2.894,8), siendo que la participación del componente años de vida saludable perdidos por discapacidad (YLD - years lost due to disability) de los hombres impulsó esta tasa hacia un 67,6% del total del DALY. Los hombres viven más tiempo con la amputación, por ello pierden más años de vida sana (65,8%), y la mortalidad es mayor entre las mujeres (61%). Las distribuciones de las tasas de DALY en el estado no mostraron distribución homogénea. La intensificación de evaluación, planificación y desarrollo de estrategias costo-efectivas para la prevención y educación en salud para el pie diabético debe ser considerada a partir de la mayor vulnerabilidad masculina