Abstract Context: Many studies show the importance of evaluating the adaptation time of subjects in a virtual driving environment, looking forwards to a response as closest as a possible real vehicle. Objectives: This study aimed to identify and analyze the adaptation to the driving simulator in older adults and middle-aged adults with and without a distraction, and a secondary aim was to identify predictors of safe performance for older adults’ drives. Design: Male and female middle-aged adults (n = 62, age = 30.3 ± 7.1 years) and older adults (n = 102, age = 70.4 ± 5.8 years) were evaluated for braking time performance in a driving simulator; cognition performance assessment included the Mini-Mental State Examination; motor evaluation included ankle flexor muscle strength with the isokinetic dynamometer and handgrip strength; the postural balance was evaluated with Timed Up and Go test, with and without a cognitive distraction task. Results: Older adults (men and women) and middle-aged adult women require more time to adapt to the driving simulator. The distractor increases the adaptation time for all groups. The main predictors of braking time for older women are age, muscle strength, and postural balance associated with distraction, and for older men, muscle strength. Conclusions: Age, sex, and distractor interfere in the adaptation of the virtual task of driving in a simulator. The evaluation model developed with multi-domains demonstrated the ability to predict which skills are related to braking time with and without the presence of the distractor.

Abstract Identifying indicators that contribute to a favourable living condition becomes of great value for the diagnosis, as well as implementing preventive and health-promoting actions. The present work objective was to evaluate and compare the lifestyle, depressive symptoms and functional aptitude of elderly men and women attending a community centre. The sample consisted of 277 elderly people, 197 (71%) women and 80 (29%) men aged above 60 years. The elderly were evaluated using a questionnaire to assess lifestyle and depressive symptoms, and their functional fitness was assessed by functional autonomy tests. The differences between the parameters were analysed by the student’s t-test and χ2 whenever appropriate. Depressive symptoms were present in 35% of the elderly; however, the lifestyle analysis showed that 57.40% of the elderly had a very good classification, followed by 24.55% as good, 17.33% as excellent and 0.72% as regular. Regarding functional fitness, 19.39% of the elderly had a score related to a very good level, 15.97% good, 16.35% fair and 45.29% weak. The results found in this study suggest that the elderly attending the community centre presented low depressive symptoms with a lifestyle classification considered very good, however, with poor functional fitness with differences in some parameters between men and women.

ABSTRACT Objective: Fatigue of the ankle’s stabilizing muscles may influence the performance of functional activities and postural control. The purpose of this study was to evaluate the performance of healthy young adults using functional jump tests and static posturography control under pre- and post-fatigue conditions of the ankle invertor and evertor muscles. Methods: Thirty physically active healthy male and female (15 male and 15 female) volunteers (24.3 years) were enrolled in this prospective cross-sectional study. Participants performed tests on one day under a non-fatigued state of invertor and evertor muscles and on the second day in a fatigued state. Tests included static posturography on a force platform in a bipedal stance with eyes open and closed and in one-legged support with eyes open and functional jump tests (figure-of-8, side hop, 6-m crossover hop, and square hop). Fatigue of the ankle invertor and evertor muscles was induced using isokinetic dynamometry with 30 repetitions at 120°/s. Results: Participants had an average age of 24.3 years (SD ± 2.08), the height of 1.73 m (SD ± 0.08), and a weight of 68.63 kg (SD ± 10.29). The average Body Mass Index (BMI) was 22.88 (SD ± 2.46). A decrease in performance was observed in functional activities and postural control under all conditions after the induction of muscle fatigue, except for the speed at a bipedal stance with eyes open. Conclusions: Functional jump tests are low cost and useful for clinical practice and evaluation of the effects of muscle fatigue and could be used in clinical practice.

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: Anterior Cruciate Ligament (ACL) injury is disabling in several sports because it causes knee instability and functional deficit. Usually, surgical treatments produce the best functional outcomes, however, sometimes they are not always able to fully restore stability and function. Objective: The objective of this study was to evaluate postural balance, muscle strength, and functional performance of young athletes with an ACL injury before and after ACL reconstruction. Design: This was a longitudinal observational prospective study. Method: 74 athletes, 60 men, and 14 women, aged between 16 and 45, divided into two groups: the Group-Lesion of ACL with 34 athletes (24.1 years) and the Group-Control with 40 athletes without ACL lesion (27.7 years old). All volunteers performed posturography, isokinetic dynamometry, and the Hop-Test. The ACL-Group was evaluated before and 12 months after the reconstruction and the control group was evaluated once. Results: The Postoperative ACL Group presented greater limb symmetry, 0.96 (± 0.12), than the preoperative ACL Group, 0.87 (± 0.17), p < 0.01 in the Hop-Test. In the posturography, the displacement area was smaller in the postoperative ACL Group, 19.85 (± 5.74), compared to the preoperative ACL Group, 24.20 (± 8.97), p < 0.01. In isokinetic dynamometry the torque peak was greater in the postoperative ACL Group, 0.91 (± 0.14), than in the preoperative ACL Group, 0.74 (± 0.15), p < 0.01. Conclusion: The functional outcomes increased in ACL reconstruction athletes after 12 months, but not at the same level as in the Control Group. The result indicates an incomplete functional recovery, adaptive changes in postural control after injury, reconstruction, and return to sport.

RESUMO Objetivo: Investigar a relação da antropometria e composição corporal com o equilíbrio postural dinâmico em idosas com baixa Densidade Mineral Óssea (DMO). Métodos: 45 idosas (≥ 60 anos), baixa DMO e diagnóstico nutricional entre baixo peso e sobrepeso. Para a avaliação da composição corporal utilizou-se a densitometria por emissão de raios x de dupla energia e exame antropométrico para aferir: massa corporal (kg), estatura (cm) e índice de massa corporal (IMC) (k/m2). A avaliação do equilíbrio postural dinâmico foi realizada pelo teste clínico mini Balance Master Evaluation System, pelo teste computadorizado Balance Master ® System e pelos testes Sit-to-Stand e Step Up/Over. Resultados: Houve correlação negativa do miniBESTest (r = − 0,566; p ≤ 0,001) e tempo de subir e descer um degrau (r = − 0,393; p ≤ 0,007) com a massa gorda, e correlação positiva do miniBESTest (r = 0,526; p ≤ 0,001) e tempo de subir e descer um degrau com a massa muscular (r = 0,297; p ≤ 0,04). Quanto às variáveis antropométricas, apenas a estatura apresentou correlação positiva (r = 0,296; p ≤ 0,04) com a velocidade no teste de sentar-se e levantar-se. Conclusão: A massa magra reduz as oscilações posturais. Em contrapartida, a massa gorda interfere de forma negativa no equilíbrio postural dinâmico de mulheres com baixa DMO. A estatura esteve relacionada ao equilíbrio postural dinâmico: quanto mais altas as idosas pior era seu equilíbrio. Nível de Evidência II, Estudos prognósticos - Investigação do efeito de característica de um paciente sobre o desfecho da doença.

ABSTRACT Objective: To investigate the relationship between anthropometry and body composition with dynamic postural balance in elderly women with low bone mineral density (BMD). Methods: 45 older women (≥ 60 years), low BMD and nutritional diagnosis of low weight to overweight. For the assessment of body composition, Dual energy X-ray emission densitometry and anthropometric examination were used to measure: body mass (kg), height (cm) and BMI (k/m2). The assessment of dynamic postural balance was performed by the mini Balance Master Evaluation System clinical test and the computerized Balance Master® System test by the Sit to Stand and Step Up/Over tests. Results: There was a negative correlation between miniBESTest (r = − 0.566; p ≤ 0.001) and time to ascend and descend step (r = − 0.393; p ≤ 0.007) with fat mass, and positive correlation with miniBESTest (r = 0.526; p ≤0.001) and time to go up and down a step with muscle mass (r = 0.297; p ≤ 0.04). As for anthropometric variables, only height showed a positive correlation (r = 0.296; p ≤ 0.04) with the speed in the sit and stand test. Conclusion: Lean mass reduces postural oscillations; in contrast, fat mass negatively interfered with dynamic postural balance in women with low BMD. Height was related to dynamic postural balance, the taller the elderly, the worse their balance. Level of Evidence II, Prognostic Studies - Investigating the Effect of a Patient Characteristic on the Outcome of Disease.

OBJECTIVE: This study aimed to analyze the physical and pulmonary capacities of hospitalized patients with severe coronavirus disease and its correlation with the time of hospitalization and complications involved. METHODS: A total of 54 patients, aged ≥18 years of both sexes, were evaluated 2-4 months after hospital discharge in São Paulo, Brazil. The physical characteristics analyzed were muscle strength, balance, flexibility, and pulmonary function. The K-means cluster algorithm was used to identify patients with similar physical and pulmonary capacities, related to the time of hospitalization. RESULTS: Two clusters were derived using the K-means algorithm. Patients allocated in cluster 1 had fewer days of hospitalization, intensive care, and intubation than those in cluster 2, which reflected a better physical performance, strength, balance, and pulmonary condition, even 2-4 months after discharge. Days of hospitalization were inversely related to muscle strength, physical performance, and lung function: hand grip D (r=−0.28, p=0.04), Short Physical Performance Battery score (r=−0.28, p=0.03), and forced vital capacity (r=−0.29, p=0.03). CONCLUSION: Patients with a longer hospitalization time and complications progressed with greater loss of physical and pulmonary capacities.

RESUMO O novo coronavírus, que causa a doença infecciosa denominada COVID-19 pela Organização Mundial de Saúde, foi notificado em dezembro, na China. As principais manifestações clínicas dos pacientes infectados são febre, tosse e dispneia. Esses pacientes têm propensão a desenvolver alterações cardíacas, miopatia difusa, diminuição da função pulmonar, diminuição da força muscular inspiratória e deterioração da capacidade funcional. Assim sendo, é esperado que os pacientes afetados pela COVID-19 sofram sequelas musculoesqueléticas em decorrência do processo inflamatório e perda de massa muscular causada pela imobilidade, que geram incapacidades motoras ainda não quantificáveis. Existe a necessidade de entender as implicações clínicas causadas pela COVID-19 para elaborar melhores estratégias de reabilitação para esses pacientes. O objetivo deste estudo foi realizar uma análise reflexiva no que tange ao impacto da COVID-19 nos sistemas imunológico, neuromuscular e musculoesquelético e no processo de reabilitação. Trata-se de uma análise reflexiva, desenvolvida no Laboratório do Estudo do Movimento do Instituto de Ortopedia e Traumatologia da Faculdade de Medicina da Universidade de São Paulo, SP, Brasil. Nesta análise, fizemos uma reflexão sobre os seguintes tópicos relacionados com a COVID-19: mecanismos imunológicos, impacto no sistemas neuromuscular e musculoesquelético e reabilitação dos pacientes. Nível de evidência V; Opinião do especialista.

ABSTRACT The new coronavirus, which causes the infectious disease named COVID-19 by the World Health Organization (WHO), was notified in 2020 in China. The main clinical manifestations in infected patients are fever, cough and dyspnoea. These patients are prone to developing cardiac changes, diffuse myopathy, decreased pulmonary function, decreased inspiratory muscle strength, and a deterioration in functional capacity. Thus, it is expected that patients affected by COVID-19 will suffer musculoskeletal consequences as a result of the inflammatory process and loss of muscle mass caused by immobility, generating motor incapacities that are not yet quantifiable. It is important to understand the clinical implications caused by COVID-19, in order to have better rehabilitation strategies for these patients. The aim of this study was to conduct a reflective analysis of the impact of COVID-19 on the immune, neuromuscular and musculoskeletal systems, and its rehabilitation process. This is a reflexive analysis, developed in the Laboratory for the Study of Movement of the Institute of Orthopaedics’ and Traumatology, at the Universidade de São Paulo School of Medicine, SP, Brazil. In this analysis, we reflect on the following topics related to COVID-19: immunological mechanisms, impact on the neuromuscular and musculoskeletal systems, and the rehabilitation of patients. Level of evidence V; Opinion of the specialist.

RESUMEN El nuevo coronavirus, que causa la enfermedad infecciosa llamada COVID-19 por la Organización Mundial de la Salud, fue notificado en diciembre en China. Las principales manifestaciones clínicas de los pacientes infectados son fiebre, tos y disnea. Esos pacientes son propensos a desarrollar cambios cardíacos, miopatía difusa, disminución de la función pulmonar, disminución de la fuerza muscular inspiratoria y deterioro de la capacidad funcional. Por lo tanto, se espera que los pacientes afectados por COVID-19 sufran secuelas musculoesqueléticas debido al proceso inflamatorio y pérdida de masa muscular causada por la inmovilidad, que generan discapacidades motoras aún no son cuantificables. Es necesario comprender las implicaciones clínicas causadas por COVID-19 para elaborar mejores estrategias de rehabilitación para estos pacientes. El objetivo de este estudio fue realizar un análisis reflexivo sobre el impacto de COVID-19, en los sistemas inmunitario, neuromuscular y musculoesquelético y en el proceso de rehabilitación. Es un análisis reflexivo, desarrollado en el Laboratorio del Estudio de Movimiento del Instituto de Ortopedia y Traumatología, Facultad de Medicina, Universidad de São Paulo, SP. En este análisis, reflexionamos sobre los siguientes temas relacionados con COVID-19: mecanismos inmunológicos, impacto en los sistemas neuromuscular y musculoesquelético y la rehabilitación de los pacientes. Nivel de evidencia V; Opinión de expertos.

OBJECTIVE: This study aimed to evaluate if posturography can be considered a recurrent fall predictor in elderly individuals. METHODS: This was a cross-sectional study. A total of 124 subjects aged 60 to 88 years were evaluated and divided into two groups—the recurrent fallers (89) and single fallers (35) groups. Patients’ sociodemographic characteristics were assessed, and clinical testing was performed. The functional test assessment instruments used were timed up and go test (TUGT), Berg Balance Scale (BBS), five times sit-to-stand test, and Falls Efficacy Scale (to measure fear of falling). Static posturography was performed in a force platform in the following three different situations—eyes open (EO), eyes closed (EC), and EO dual task. RESULTS: There were significant differences between the single and recurrent fallers groups regarding the fear of falling, the Geriatric Depression Scale score, the mean speed calculated from the total displacement of the center point of pressure (COP) in all directions with EO, and the root mean square of the displacement from the COP in the mediolateral axis with EC. Based on the hierarchical logistic regression model, none of the studied posturographic variables was capable of significantly increasing the power of differentiation between the recurrent and single fallers groups. Only TUGT with a cognitive distractor (p<0.05) and the BBS (p<0.01) presented with significant independent predictive power. CONCLUSION: TUGT with a cognitive distractor and the BBS were considered recurrent fall predictors in elderly fallers.

RESUMO Objetivos Determinar a incidência e a intensidade álgica e os locais mais acometidos por lesões com dor musculoesquelética e incidência e gravidade das “lesões definidas por tempo de afastamento” em jogos e treinos de árbitros de futebol, em um triênio. Métodos Foram entrevistados 257 árbitros utilizando-se um aplicativo da web. Com essa ferramenta, foi enviada aos árbitros uma ficha de avaliação mensal com questões que mediam incidência, localização e intensidade álgica das lesões com queixas de dor e por tempo de afastamento, gravidade em jogos e treinos nos anos de 2012, 2013 e 2014. Para classificar a intensidade álgica das lesões com queixas utilizou-se a escala numérica de dor. Resultados Não houve diferença entre os anos estudados com relação às lesões com queixas de dor, tanto em jogos quanto em treinos. Os valores médios foram de 37,8/1.000 horas em jogos e 39,9/1.000 horas em treinos e a incidência média de “lesões definidas por tempo de afastamento” de 3,7/1.000 horas em jogos. A diferença foi significantemente maior em 2013 com relação a 2012 e 2014 e, em treinos, a incidência média foi de 3,5/1.000 horas com diferença significantemente superior em 2012 com relação a 2013 e 2014. Conclusão As lesões com queixas de dor não apresentaram diferença significante em jogos comparados com treinos; nas lesões por tempo de afastamento, a incidência em jogos foi maior do que em treinos, e o tipo de lesão mais frequente foi a muscular de grau leve, predominando na coxa e no tríceps sural. Nível de evidência II, Estudos diagnósticos – Investigação de um exame para diagnóstico.

ABSTRACT Objectives To determine the incidence and intensity of pain and the areas most affected by injuries with musculoskeletal pain, and the incidence and severity of “injuries defined by time of leave” in games and training of soccer referees in a triennium. Methods An interview was conducted with 257 referees using a web application. With this tool, a monthly evaluation form was sent to the referees with questions that measured the incidence, location, and pain intensity of injuries with complaints of pain and time of leave, severity in games and training in the years 2012, 2013, and 2014. The numerical pain scale was used to classify the pain intensity of the lesions with pain complaint. Results There was no difference between the years studied in relation to injuries with pain complaints, both in games and in training. Mean values were 37.8/1,000 hours in games and 39.9/1,000 hours in training, with a mean incidence of “ injuries defined by time of leave” of 3.7/1,000 hours in games. The difference was significantly higher in 2013 compared to 2012 and 2014, and in training, the average incidence was 3.5/1,000 hours, with a significantly higher difference in 2012 compared to 2013 and 2014. Conclusion Lesions with pain complaints did not present a significant difference in games compared to training; in the lesions by time of leave, the incidence in games was higher than in training, and the most frequent type of injury was low-degree muscle pain, predominantly in the thigh and triceps surae. Level of Evidence II; Prognostic Study - Investigating the Effect of Patient Characteristics on Disease Outcome.

RESUMEN Objetivos Determinar la incidencia y la intensidad del dolor y los lugares más afectados por lesiones con dolor musculoesquelético e incidencia y gravedad de las “lesiones definidas por tiempo de licencia” en juegos y entrenamientos de árbitros de fútbol en un trienio. Métodos Fueron entrevistados 257 árbitros utilizando una aplicación de la web. Con esta herramienta, se envió a los árbitros una ficha de evaluación mensual con cuestiones que medían incidencia, localización, intensidad de las lesiones con quejas de dolor y por tiempo de licencia, gravedad en juegos y entrenamientos en los años 2012, 2013 y 2014. Para clasificar la intensidad del dolor de las lesiones con quejas se utilizó la escala numérica de dolor. Resultados No hubo diferencia entre los años estudiados en relación a las lesiones con quejas de dolor, tanto en juegos como en entrenamientos. Los valores promedio fueron de 37,8/1.000 horas en juegos y 39,9/1.000 horas en entrenamientos, siendo la incidencia media de “lesiones definidas por tiempo de licencia” de 3,7/1.000 horas en juegos. La diferencia fue significantemente mayor en 2013 con respecto a 2012 y 2014 y en los entrenamientos, la incidencia media fue de 3,5/1.000 horas con una diferencia significantemente superior en 2012 con respecto a 2013 y 2014. Conclusión Las lesiones con quejas de dolor no presentaron diferencia significativa en juegos comparados a los entrenamientos; en las lesiones por tiempo de licencia, la incidencia en juegos fue mayor que en entrenamientos, y el tipo de lesión más frecuente fue la muscular de grado leve, predominio en el muslo y tríceps sural. Nivel de evidencia II, Estudios de diagnósticos - Investigación de un examen para diagnóstico.

RESUMO Objetivo: Acompanhar a densidade mineral óssea (DMO) e a composição corporal, ao longo de seis anos, em idosos corredores de longa distância. Métodos: analisamos os prontuários médicos de um grupo de atletas idosos, corredores de longa distância, participantes do Grupo de Ortogeriatria do IOT-HC-FMUSP, e reunimos todos os atletas que tiveram a DMO avaliada no ano de 2001 e de 2007, sendo destes, 11 prontuários selecionados. Critérios de inclusão: ser corredor de longa distância; não parar de correr ao longo dos seis anos e ter os dois exames de DMO e composição corporal avaliados. A composição corporal foi avaliada por meio de densitometria óssea, com uma dupla energia de absorção de raios-X (DEXA), em um aparelho LUNAR-DPX. Resultados: Ao longo dos seis anos, a composição corpórea se manteve estável, havendo apenas um aumento significante na gordura expressa em (%) (p=0,003). Conclusão: A corrida de longa distância parece conservar a DMO de idosos corredores, porém com aumento de gordura. Nível do Evidência II; Estudos prognósticos - Investigação do efeito de características de um paciente sobre o desfecho da doença.

ABSTRACT Objective: To evaluate bone mineral density (BMD) and body composition over a six-year period in elderly long-distance runners. Methods: We analyzed the medical records of elderly athletes who were long-distance runners, were participants of the IOT-HCFMUSP Orthogeriatric Group, and had their BMD evaluated between 2001 and 2007; of these athletes, 11 were included in the study. Inclusion criteria: athletes should be long-distance runners, should not stop long-distance running during the six-year period, and should have undergone BMD and body composition evaluations. Body composition was evaluated using bone densitometry with dual-energy X-ray absorptiometry with a Lunar-DPX device. Results: Over the six-year period, body composition remained stable, but there was a significant increase only in the fat percentage (p = 0.003). Conclusion: Long-distance running may maintain BMD but may lead to an increase in the fat percentage in elderly runners. Level of Evidence II; Prognostic Study - Investigating the Effect of Patient Characteristics on Disease Outcome.

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.

OBJECTIVES: This study sought to analyze the extent of motor adaptation in ankle plantar flexors and dorsiflexors among older drivers during clinical isokinetic testing. METHODS: One hundred older adults (70.4±5.7 years) participated in two bilateral ankle plantar flexor and dorsiflexor isokinetic assessments at 30°/sec. Peak torque (PTQ), PTQ adjusted for body weight (PTQ/BW), and total work (TW) were analyzed. RESULTS: On the dominant side, PTQ/BW and TW were significantly greater for the second plantar flexion test than were those for the first such test (p<0.001), whereas PTQ, PTQ/BW, and TW (p<0.001) were significantly greater for the second dorsiflexion test than were those for the first such test. On the non-dominant side, plantar flexion PTQ and TW were significantly lower for the second test than were those for the first test (p<0.001). CONCLUSION: Older drivers demonstrated better performance with the dominant limb on the second test. The low variability in test execution showed the existence of a motor adaptation effect for the tested movements, despite the short recovery period between the assessments.

OBJECTIVE: To compare Kendo players with active elderly adults in terms of quality of life, functional aspects (muscle strength, postural balance) and body composition. METHODS: This was a controlled cross-sectional study. Twenty elderly individuals were divided into two groups: the Kendo group, with an average age of 71.8 (5.4) years, and the Control group, with an average age of 73.1 (4.8) years. Quality of life was evaluated using a questionnaire (WHOQOL-bref and WHOQOL-old); body composition was evaluated with a bioimpedance scale (InBody230); hand-grip strength was assessed with a portable manual dynamometer (Jamar SH 5001); flexor and extensor muscle strength of the knees was evaluated with an isokinetic device (Biode® System 3 model Biodex Multi Joint System, BIODEX); and dynamic balance was assessed using a force platform (Balance Master System, Neurocom International, Inc.,® Clackamas County, Oregon, USA). RESULTS: The groups were statistically homogeneous in terms of socio-demographic characterization, body composition, muscle strength, and dynamic balance, but the Control group was faster in the sit-to-stand test (p=0.03). The Kendo group had a statistically significantly better quality of life; in the WHOQOL-bref, these differences were present in the physical (p≤0.001) and environment (p=0.004) domains, and in the WHOQOL-old, these differences were present in social participation (p=0.001) and in past, present, and future activities (p=0.019). CONCLUSION: The results suggest that Kendo is a health-promoting activity that improves the quality of life, functional aspects (muscle strength and postural balance) and body composition of players.

BASES: O Índice de Desvio da Marcha, inicialmente utilizado para avaliar a marcha de crianças com paralisia cerebral, tem sido utilizado como parâmetro quantitativo de alterações de marcha de indivíduos com outras condições. No entanto, não existem estudos que avaliem alterações no padrão de marcha de indivíduos hemiparéticos crônicos pós-AVC com base nesse índice. OBJETIVOS: Caracterizar as alterações no padrão de marcha de acordo com o Índice de Desvio da Marcha e parâmetros espácio-temporais da marcha de sujeitos hemiparéticos crônicos em relação a indivíduos saudáveis. MÉTODOS: Estudo retrospetivos. Os dados foram obtidos a partir da base de dados do Laboratório de Marcha do Hospital Israelita Albert Einstein. Trinta indivíduos foram incluídos neste estudo, com AVC unilateral, isquêmico ou hemorrágico, crônico (tempo pós-lesão> 6 meses) e habilidade de caminhada classificada como 2, 3, 4 ou 5 segundo a Categoria de Ambulação Funcional. Os dados de 87 indivíduos saudáveis foram incluídos no grupo controle, obtido a partir da base de dados de normalidade. A análise estatística foi aplicada através do teste de Kruskall Wallis, seguido do teste pós-hoc de Mann-Whitney, considerando um valor p crítico <0,05. RESULTADOS: Os valores observados para o Índice de Desvio da Marcha foram menores para os membros paréticos (64,69 ± 16,29) e não-paréticos (64,88 ± 15) em relação ao controle (101,01 ± 10,12; p <0,001). Não foram observadas diferenças nos escores do Índice de Desvio da Marcha entre os membros paréticos e não paréticos (p> 0,99). CONCLUSÃO: Os achados do presente estudo demonstram que o Índice de Desvio da Marcha pode ser um parâmetro sensível para identificar alterações no padrão de marcha de indivíduos hemiparéticos crônicos pós-AVC.

BACKGROUND: The Gait Deviation Index, initially conceived to evaluate the gait of children with cerebral palsy, has been used as a quantitative parameter of gait pattern changes of individuals with other conditions. However, there are no studies evaluating changes in the gait pattern of chronic hemiparetic post-stroke subjects based on this index. AIMS: To characterize the changes in gait pattern according to the Gait Deviation Index and gait spatiotemporal parameters of chronic hemiparetic subjects compared to healthy subjects. METHODS: Retrospective study. Data were obtained from the database of the Gait Laboratory of Hospital Israelita Albert Einstein. Thirty subjects were included in this study, with previous unilateral, ischemic or hemorrhagic chronic stroke (time post-lesion > 6 months) and ability of walking classified as 2, 3, 4 or 5 according to Functional Ambulation Category. Data from 87 healthy subjects were included in control group, obtained from a normality database. Statistical analysis was applied through the Kruskall Wallis test, followed by Mann-Whitney post-hoc test, considering a critical p value <0.05. RESULTS: The Gait Deviation Index scores were decreased for both paretic (64.69 ± 16.29) and non-paretic limbs (64.88 ± 15.00) compared to control (101.01 ± 10.12; p < 0.001). No differences were observed in Gait Deviation Index scores between paretic and non-paretic limbs (p > 0.99). CONCLUSION: The findings of the current study demonstrate that the Gait Deviation Index may be a sensitive parameter to identify changes in the gait pattern of chronic hemiparetic post-stroke subjects.