Introdu??o: Existem muitas equa??es para estimar a for?a muscular respirat?ria (FMR) com diferentes valores preditivos. Assim, a equa??o escolhida pode influenciar, de forma decisiva, no diagn?stico da situa??o dos m?sculos respirat?rios e interferir na tomada de decis?o cl?nica. A equa??o de refer?ncia escolhida torna-se t?o relevante quanto a t?cnica correta e o resultado aferido. Objetivo: Comparar o valor preditivo de 4 equa??es de refer?ncia com os valores da FMR: press?o inspirat?ria m?xima (PIm?x) e a press?o expirat?ria m?xima (PEm?x), mensurados em idosos neuropatas e indicar a(s) equa??o(?es) que melhor se ajusta(m). M?todo: Estudo observacional anal?tico. As capacidades de 4 equa??es preditivas foram comparadas com a FMR mensuradas em 220 idosos, sendo 108 neuropatas funcionais e 112 controles h?gidos. Para verificar a normalidade dos dados foi utilizado o teste Shapiro-wilk, foram realizadas an?lises descritivas. Para avaliar os fatores que influenciavam o estado de sa?de dos participantes (h?gido ou neuropata) foi realizada an?lise das compara??es via testes Qui-Quadrado e teste de Mann-Whitney. Para a correla??o das vari?veis peso e IMC entre os idosos com fraqueza muscular respirat?ria, foi utilizada a correla??o de Pearson. A compara??o entre os valores preditos por cada equa??o e os valores mensurados foi feita por interm?dio do ajuste de um modelo de Regress?o Log?stica. Para verificar o ajuste a capacidade preditiva do modelo foram calculadas: ?rea sob a curva ROC (AUC), Sensibilidade, Especificidade, Valor Preditivo Positivo (VPP), Valor Preditivo Negativo (VPN) e Acur?cia (ACC), e as medidas de qualidade de ajuste das equa??es: R?, mean absolute deviation (MAD), mean absolute percentage error (MAPE) e o root mean square error (RMSE), estabelecemos um ranking de classifica??o segundo a capacidade preditiva. O software utilizado foi o R (vers?o 3.5.1). Resultados: Nenhuma das equa??es foi capaz de prever a PImax da amostra estudada. Nos idosos neuropatas, a equa??o de Neder apresentou melhor potencial em predizer a PIm?x (maior AUC) e melhor capacidade preditiva no rancking geral. Para a PEm?x a equa??o de Sanchez E1 foi a que mais se ajustou com melhor capacidade preditiva quando analisada VPP, VPN, ACC e AUC. Conclus?o: Para os valores de refer?ncia da FMR em idosos neuropatas a equa??o de Neder foi a mais ajustada aos valores mensurados da PIm?x e a equa??o de Sanchez E1 foi a mais ajustada aos valores mensurados da PEm?x.

Introduction: There are many equations to estimate respiratory muscle strength (RMS) with different predictive values. Thus, the chosen equation can decisively influence the diagnosis of the situation of the respiratory muscles and interfere with clinical decision-making. The chosen reference equation becomes as relevant as the correct technique and the measured result. Objective: To compare the predictive value of 4 reference equations with the FMR values: maximum inspiratory pressure (MIP) and maximum expiratory pressure (MEP), measured in elderly neuropaths and indicate…

Introdu??o: O Acidente Vascular Cerebral (AVC) ? um dos principais causadores de incapacidade e mortalidade no mundo. Suas consequ?ncias funcionais s?o heterog?neas e v?o al?m da defici?ncia/incapacidade/desvantagem para a realiza??o das atividades instrumentais da vida di?ria. Na fase aguda, fraqueza muscular, incluindo fraqueza da musculatura respirat?ria, e disfagia, contribui para infec??o pulmonar e morbimortalidade. Entretanto, embora alguns estudos sobre a for?a muscular respirat?ria (FMR), importante marcador de capacidade ventilat?ria e preditor de desempenho global, especialmente em indiv?duos com disfun??es neurol?gicas, tenham sido conduzidos em indiv?duos p?s-AVC na fase aguda, ainda pouco se sabe sobre tal vari?vel na fase cr?nica e, muito menos, sua associa??o com o risco de disfagia. Objetivo: Investigar a FMR e o risco de disfagia em idosos p?s-AVC isqu?mico (AVCi) em fase cr?nica. Os desfechos prim?rios de interesse foram a press?o inspirat?ria m?xima (PIm?x) e a press?o expirat?ria m?xima (PEm?x). O desfecho secund?rio foi o risco de disfagia e sua associa??o com a FMR. M?todo: Estudo transversal aprovado pelo comit? de ?tica em pesquisa cient?fica (CAAE 83573318.2.0000.5020 e parecer n? 2.520.8810). A FMR foi mensurada pela manovacuometria e o risco de disfagia pelo Eating Assessment Toll (EAT-10). Para mensurar o grau de incapacidade foi utilizada a medida de independ?ncia funcional (MIF). Os dados foram analisados pelo programa Epi Info vers?o 7.2 para Windows e apresentados por meio de tabelas, com frequ?ncias absolutas simples e relativas para os dados categ?ricos. Na an?lise dos dados quantitativos, quando rejeitada a hip?tese de normalidade por meio do teste de Shapiro-Wilk, foi calculada a mediana e os quartis (Qi). Na an?lise dos dados categorizados foi aplicado o teste do qui-quadrado ou o teste exato de Fisher. Na compara??o das medianas foi calculado o teste de Mann-Whitney ou Kruskal-Wallis. Para a an?lise da correla??o entre a FMR e o risco de disfagia foi utilizado o teste de Pearson. Foi considerado o n?vel de signific?ncia de 5%. Resultados: A FMR dos idosos p?s-AVCi em fase cr?nica foi menor do que a de seus controles pareados por sexo, idade e ?ndice de massa corporal (PImax p=0,002 e PEmax p<0,001) e a maioria deles apresentou fraqueza muscular respirat?ria. O risco de desenvolver disfagia foi baixo nos idosos p?s-AVCi na fase cr?nica, entretanto, aumentou quando associado a fraqueza muscular expirat?ria. A FMR dos idosos p?s-AVCi na fase cr?nica, se correlacionou negativamente com o risco de disfagia (PIm?x r = -0,629; PEm?x r = -0,399). Conclus?o: Mesmo na fase cr?nica p?s-AVCi, idosos apresentam fraqueza muscular respirat?ria e essa, aumenta a probabilidade de disfagia.

Introduction: Stroke is one of the leading causes of disability and mortality in the world. Its functional consequences are heterogeneous and go beyond disability/disadvantage to perform instrumental activities of daily living. In the acute phase, muscle weakness, including…

Submitted by Nadir Basilio ([email protected]) on 2018-07-20T20:50:03Z No. of bitstreams: 1 Vanderson Cunha do Nascimento.pdf: 1194346 bytes, checksum: ddb63f49374d9261ba822c5740a4bddf (MD5)

Made available in DSpace on 2018-07-20T20:50:04Z (GMT). No. of bitstreams: 1 Vanderson Cunha do Nascimento.pdf: 1194346 bytes, checksum: ddb63f49374d9261ba822c5740a4bddf (MD5) Previous issue date: 2018-03-08

Objective: to verify in elderly women practitioners of resistance training (RT) the behavior of Maximum Inspiratory Pressure (Mip) and Expiratory (Mep), amplitude ring, Axillary (AAx), Xifoideana (AXi) and Abdominal (AAb), the peak of Expiratory flow (PEF) and the distance travelled in Incremental Shuttle Walk Test (ISWT). Methodology: Two studies were developed with elderly women aged between 60 and 79 years. In study I, the sample consisted of 53 elderly women divided into two groups. The group of trained (GT) was composed of 28 women participants of a RT program and the group of non-trained (GNT) was composed of 25 sedentary or irregularly active women. In study II, the sample consisted of 24 elderly women, sedentary or irregularly active, who underwent a 12-week RT program. The elderly women were evaluated for Mip and Mep with the use of manovacuometry, thoracoabdominal amplitudes by cirtometry, PEF using the PEF or Peak-Flow meter and walking performance through the ISWT. In the statistical analysis in the study I was applied the Unpaired Student's t-Test and in Study II Student's t-Test was applied for related samples. The Pearson Correlation Test was used to correlate the respiratory variables with the distance covered in the ISWT. The level of significance was p ??? 0.05. RESULTS: In the study I of the walk and the respiratory variables studied, except for AAb, found significant and superior differences in GT in relation to GNT, as well as in study II in the post-RT study. Correlation between respiratory variables and ISWT performance was only observed between this and AXi in study I. Conclusion: In study I, elderly women participating in a RT extension program presented higher and significant differences in Mip, Mep, AAx , AXi, Peak-Flow and performance in the ISWT when compared to sedentary or irregularly active elderly women, as well as, showed a significant correlation between AXi and ISWT performance. In study II, the RT promoted significant changes in respiratory variables and walking performance, except in AAb, however, no correlation was found between the respiratory variables studied and the results in the ISWT.

Objetivo: Verificar em mulheres idosas praticantes de Treinamento Resistido (TR) o comportamento das Press??es M??ximas Inspirat??ria (PIm??x) e Expirat??ria (PEm??x), das Amplitudes toracoabdominal, Axilar (AAx), Xifoideana (AXi) e Abdominal (AAb), do Pico de Fluxo Expirat??rio (PFE) e da dist??ncia percorrida no Incremental Shuttle Walk Test (ISWT). Metodologia: Foram desenvolvidos dois estudos com mulheres idosas com idade entre 60 e 79 anos. No estudo I, a amostra foi…

Submitted by Nadir Basilio ([email protected]) on 2018-07-20T20:10:21Z No. of bitstreams: 1 Erica Feio Carneiro Nunes.pdf: 1021018 bytes, checksum: 040c57768f7aed071b8aa73bd056ade6 (MD5)

Made available in DSpace on 2018-07-20T20:10:21Z (GMT). No. of bitstreams: 1 Erica Feio Carneiro Nunes.pdf: 1021018 bytes, checksum: 040c57768f7aed071b8aa73bd056ade6 (MD5) Previous issue date: 2018-03-06

Contextualization: Weakening of pelvic floor muscles (PMFs) has been considered a major cause of stress urinary incontinence (SUI). In this way, the physiotherapeutic treatment, classically, turned to the strengthening of these muscles. In this study it was hypothesized that, in addition to PMFs weakness, this dysfunction may also be related to a change in the pattern of reflex response of these muscles. Objective: The study objectives were to compare the contraction response time and strength of cough-induced PMFs among continents and SUI women, and to conduct a literature review on the use of biofeedback for pelvic floor muscle training in women with this dysfunction. Methods: Study II: A systematic review was conducted with a search of the databases Science Direct, Embase, MEDLINE, Pedro, SciELO, CINAHL and LILACS for randomized clinical trials that had biofeedback (BF) as a therapeutic tool for SUI. Study II: This was a cross-sectional study that evaluated the cough PMFs of 20 healthy women and 20 women with SUI. The clinical evaluation consisted of the application of questionnaires that assessed the severity of urinary incontinence and quality of life. Signal capture was performed with a 4-channel acquisition system (EMG System do Brasil Ltda??) to capture the signals obtained through vaginal dynamometry, electromyography (EMG) of the right external obliquus muscle and accelerometry. Statistical analysis was performed using the Shapiro-Wilk, independent t test or Mann-Whitney test according to the data distribution and the covariance analysis (ANCOVA) with post hoc Bonferrone test. The statistical significance considered for all tests was p <0.05. Results: Study I: the training of the PMFs with BF was not better than the control group (without training and orientation, vaginal electrical stimulation). However, these contradictory results and poor quality of the studies are probably not clinically significant. Study II: the contraction response of the PMFs was significantly different between the groups for the activation time of the PMFs (F = 19.51, P <0.0001, ???p2= 0.61), external oblique muscle activation time (F = 11.41, P <0.002, ???p2= 0.23) and time of the cough pulse (F = 4.21, P <0.04, ???p2= 0.10). Conclusion: The systematic review provides evidence that the training of BF-PMFs does not offer superior therapeutic benefits to other types of interventions in the treatment of female SUI. The cross-sectional study showed that women with SUI have delayed cough-induced contraction of PMFs.

Contextualiza????o: O enfraquecimento dos m??sculos do assoalho p??lvico (MAPs) tem sido considerada uma das principais causas…

Submitted by Nadir Basilio ([email protected]) on 2018-07-19T17:34:53Z No. of bitstreams: 1 Karina Moyano Amorim.pdf: 916717 bytes, checksum: 2524cea0e3065649a660dc46e7c08c81 (MD5)

Made available in DSpace on 2018-07-19T17:34:53Z (GMT). No. of bitstreams: 1 Karina Moyano Amorim.pdf: 916717 bytes, checksum: 2524cea0e3065649a660dc46e7c08c81 (MD5) Previous issue date: 2017-12-18

Changes in pelvic floor muscles (PMF) that occur in stress urinary incontinence (SUI) can be quantified using a transvaginal dynamometer. The objective of this study was to compare and test the accuracy of different parameters obtained by a transvaginal force dynamometer, from contraction of MAP, between healthy and SUI women. Seventeen healthy women (CG) and 17 women with stress urinary incontinence (GSUI) aged 20-60 years were included in this study. The MAP strength was evaluated by means of a transvaginal dynamometer, in a single test session. The data were collected with the patient in lithotomy, and the volunteers were instructed to perform a maximal contraction of the MAP and resist until exhaustion. The test was repeated three times with a 1 minute interval between tests. The dynamometric parameters used to evaluate the MAPs were: peak time (time at which the peak force occurred from the beginning of the MAP contraction), baseline (passive force), maximum force value of MAP contraction, contraction and mean contraction force of the MAP and endurance. The covariance analysis (ANCOVA) with Bonferrone's post hoc test showed that only the endurance variable was different between the groups (F=4.87, P=0.03; ???p2= 0.14). The accuracy of endurance to identify women with SUI was verified by the receiver operating characteristic curve (ROC). The area on the curve was 0.76 and the sensitivity and specificity were 76.60% for both conditions. In this study it was possible to verify that only the variable muscular resistance has moderate accuracy to identify women with stress urinary incontinence.

As altera????es dos m??sculos do assoalho p??lvico (MAP) que ocorrem na incontin??ncia urin??ria por esfor??o (IUE) podem ser quantificadas por meio de dinam??metro transvaginal. O objetivo deste estudo foi comparar e testar a acur??cia de diferentes par??metros obtidos por um dinam??metro de for??a transvaginal, a partir da contra????o dos MAP, entre mulheres saud??veis e com IUE. Fizeram parte desse estudo, 17 mulheres saud??veis (GC) e 17 com incontin??ncia urin??ria por esfor??o (GIUE) com faixa et??ria de 20 a 60 anos. A avalia????o da for??a dos MAP foi realizada por meio de um dinam??metro transvaginal, em uma ??nica sess??o de teste. Os dados foram coletados com a paciente em litotomia, sendo as volunt??rias instru??das a realizar uma contra????o m??xima dos MAP e resistir at?? a exaust??o. O teste foi repetido por tr??s vezes com intervalo de 1 minuto entre as coletas. Os par??metros dinamom??tricos utilizados para avaliar os MAP foram: tempo do pico (tempo em que ocorreu o pico de for??a a partir do in??cio da contra????o dos MAP),…

Submitted by PPG Gerontologia Biom?dica ([email protected]) on 2017-11-20T10:28:02Z No. of bitstreams: 1 FERREIRA_OLIVEIRA_LEONARDO_TESE.pdf: 7911824 bytes, checksum: 45902ffd315db92b8af53a56e81440f3 (MD5)

Approved for entry into archive by Caroline Xavier ([email protected]) on 2017-11-28T17:26:16Z (GMT) No. of bitstreams: 1 FERREIRA_OLIVEIRA_LEONARDO_TESE.pdf: 7911824 bytes, checksum: 45902ffd315db92b8af53a56e81440f3 (MD5)

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Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES

Introduction: Botulinum toxin is a zinc-dependent metalloprotease and promotes cleavage of the receptor responsible for botulinum toxin type A with consequent paralysis at the neuromuscular junction. In addition to blocking the release of acetylcholine, it inhibits the local release of pain-related neuropeptides. Although more recognized in aesthetics, it is indicated in the treatment of several disorders. Objective: To evaluate the efficacy and duration of the effect of botulinum toxin type A (incobotuliniumtoxin A) applied to the frontal muscle of women, being reconstituted in zinc gluconate compared to dilution in physiological solution. Methods: This is a prospective, double-blind study. The sample size was 48 females, over 50 years of age and divided into two groups, being calculated using the G-Power program to verify the association between variables. For this purpose an effect of 0.5, a power of the test of 80% and a level of confidence of 95% were used. The comparison between the two groups was performed by the Mann-Whitney test. The non-parametric test was chosen because the variables had no normal distribution (Kolmogorov-Smirnov p> 0.05). The various moments were compared by the Kruskall-Wallis test. In the control group, Incobotuliniumtoxin A flasks (100 U) were diluted in 2 mL of 0.9% sodium chloride physiological solution. In the case group, it was diluted with 2 mL of a 0.02% zinc gluconate solution. Participants were monitored using the Merz-Esthetics validated scale of resting and moving frontal lines and documented by means of digital photography, the results of which were analyzed by Wilcoxon's non-parametric test to compare the frontal lines before and after the application. To characterize the groups, descriptive statistics methods were used as frequencies and percentages for categorical variables and median, minimum and maximum for quantitative variables. The chi-square and Manny-Whitney tests were used to verify the homogeneity of the groups in relation to the clinical variables. Results: The results showed that there is no relationship between race, ethnicity, smoking and sunscreen use with the toxin effect in the two groups. For the variables age and amount weekly zinc intake the Manny-Whitney test result indicated that there was no significant difference in the groups.…

Submitted by Caroline Xavier ([email protected]) on 2017-06-29T12:05:10Z No. of bitstreams: 1 TES_VERONICA_BAPTISTA_FRISON_PARCIAL.pdf: 2069499 bytes, checksum: aa6537076bca37dc159c3291dcc3c904 (MD5)

Approved for entry into archive by Caroline Xavier ([email protected]) on 2017-06-29T12:05:22Z (GMT) No. of bitstreams: 1 TES_VERONICA_BAPTISTA_FRISON_PARCIAL.pdf: 2069499 bytes, checksum: aa6537076bca37dc159c3291dcc3c904 (MD5)

Made available in DSpace on 2017-06-29T12:05:34Z (GMT). No. of bitstreams: 1 TES_VERONICA_BAPTISTA_FRISON_PARCIAL.pdf: 2069499 bytes, checksum: aa6537076bca37dc159c3291dcc3c904 (MD5) Previous issue date: 2016-11-11

Background: Traumatic spinal cord injury (TSCI) is a severe, incapacitating, neurological syndrome that leads to changes in sensitivity, motor function, and the autonomic system of body segments located below the level of injury. Although it is one of the most devastating injuries and poses multiple challenges for the patients, family, and clinicians involved, physical therapy can lead to neurological improvements in patients with TSCI. The purpose of this study was to evaluate the effects of corporal suspension and pendulum exercises (CHORDATA? method) on torque, muscle activation, muscle thickness, and functionality in patients with TSCI. Methods: This study was a randomized, controlled clinical trial including 26 male TSCI patients (in whom injury occurred up to 3 years earlier at the thoracic level; age, 18?65 years). The subjects were categorized into two groups: an intervention group (IG; n = 14) and a control group (CG; n = 12). Before and after a rehabilitation program, which comprised 16 sessions of suspension and pendulum exercises (twice/week, 50 minutes/session), we evaluated the following parameters in each subject: maximal voluntary isometric trunk flexion and extension torques; electromyographic activity of the external oblique, rectus abdominis, and longissimus muscles; muscle thickness of the external oblique, internal oblique, transversus abdominis, rectus abdominis, and multifidus muscles; and functionality (adapted reach test). Mean ? standard deviation values were used to summarise continuous data, which were then compared at the baseline using t-tests. Categorical variables were expressed as counts and percentages. Between-group baseline differences were assessed using chi-square or Fisher?s exact tests, as required. Analysis of covariance, with adjustments for baseline measurements, was conducted to evaluate between-group differences after the 16 exercise sessions. The results were presented as mean ? standard deviation with the estimated adjusted difference between groups, followed by 95% confidence intervals. The study significance level was set at ? = 0?05. Data were analysed using SPSS version 22.0 (SPSS, Inc., Chicago, USA).This trial is registered with Clinical Trials.gov,NCT02316067. Findings: The CG and IG patients had similar ages (p = 0?93), injury time (p = 0?41), injury level (p = 0?27), injury…

Submitted by Setor de Tratamento da Informa??o - BC/PUCRS ([email protected]) on 2016-05-17T11:17:38Z No. of bitstreams: 1 DIS_CRISTHIELE_TAIS_WOSZEZENKI_PARCIAL.pdf: 460185 bytes, checksum: 0a97ea104058f0cf129ef176df86e909 (MD5)

Made available in DSpace on 2016-05-17T11:17:38Z (GMT). No. of bitstreams: 1 DIS_CRISTHIELE_TAIS_WOSZEZENKI_PARCIAL.pdf: 460185 bytes, checksum: 0a97ea104058f0cf129ef176df86e909 (MD5) Previous issue date: 2016-03-28

Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES

Objectives: To generate reference values for two inspiratory muscle endurance protocols (IME) in healthy children and adolescents. Methods: An observational, cross-sectional study was conducted including healthy children and adolescents between 4 and 18 years old. Body weight, height, maximal inspiratory pressure (MIP) and IME (using two protocols) measurements were performed. In the incremental threshold loading a fixed load of 30% of the MIP with an increase of 10% every 2 minutes was used. In the a fixed load of 70% of the MIP was used and the time limit (Tlim) to exhaustion was measured. Results: In total, 462 participants were included, 281 performed the incremental threshold loading and 181 the maximum load protocol. There were moderate and positive correlations between IME and age, MIP, height and weight in the incremental threshold loading. However, the regression model showed that MIP and age were the best variables to predict RMI. In the maximum load protocol, weak and positive correlations with age, weight and height were found. In the regression model for this protocol, only age and height influenced the endurance. The prediction power (R2) for the incremental threshold loading was 0.65, while for the maximum load protocol was 0.15. Reproducibility measured by the intraclass correlation coefficient (ICC) was higher in the incremental threshold loading (0.96) compared to the maximum load protocol (0.69). Conclusion: The IME in healthy children and adolescents can be explained by age, height and MIP. The incremental threshold loading showed better results and should be the model of choice when evaluating IME in the pediatric age group.

Objetivos: Gerar valores de refer?ncia para dois protocolos de resist?ncia muscular inspirat?ria (RMI) em crian?as e adolescentes saud?veis. M?todos: Estudo observacional, transversal, em crian?as e adolescentes saud?veis de 4 a 18 anos. Foram realizadas as mensura??es de peso, altura, press?o inspirat?ria m?xima (PIMAX) e RMI, utilizando-se dois protocolos. No protocolo de carga incremental foi utilizada uma carga fixa de 30% da PIMAX com incremento de 10% a cada 2 minutos. J? no protocolo de carga m?xima foi utilizada uma carga fixa de 70% da PIMAX e mensurado o tempo limite (Tlim) alcan?ado at? a exaust?o. Resultados: Foram inclu?dos 462 participantes, sendo 281 correspondentes ao protocolo de carga incremental e 181 ao de carga m?xima. No protocolo de carga incremental, houve correla??es moderadas e positivas entre a RMI e a idade, PIMAX, peso e altura. No…

Submitted by Nadir Basilio ([email protected]) on 2016-05-24T21:11:50Z No. of bitstreams: 1 Fernanda Cordeiro da Silva.pdf: 1698143 bytes, checksum: 5188d9f0e1735fda1e319f632fa9f199 (MD5)

Made available in DSpace on 2016-05-24T21:11:50Z (GMT). No. of bitstreams: 1 Fernanda Cordeiro da Silva.pdf: 1698143 bytes, checksum: 5188d9f0e1735fda1e319f632fa9f199 (MD5) Previous issue date: 2015-12-17

Cerebrovascular Accident (Stroke) is an important aggravation to the health of the global population, which causes motor impairments that could compromise the masticatory muscles. The objective of this study was to evaluate complete hemiparesis, originating from a Stroke, which may cause greater orofacial compromise, altering the electromyographic activity and the force of the masticatory muscles associated to the temporomandibular dysfunction when compared to incomplete hemiparesis. Hemiparetic post-stroke individuals aged between 18 and 75 years of age were evaluated. The sample was divided into two groups: the Complete Hemiparetic group containing 29 individuals and the Incomplete Hemiparetic group containing 21 individuals. All of the groups were submitted to evaluation to diagnose TMD through RDC/TMD, bite force through the Kratos?? Dynamometer and electromyography of the masticatory muscles employing a 4-channel electromyography of the EMG System??. The results obtained were computed and the statistical analysis was made using the significance of 95% (p<0.05), where the significant statistical difference was observed in the TMD between the complete and incomplete hemiparetic group (p=0,01). However, regarding the bite force in the intergroup and/or intragroup, a statistical difference was not observed. As to the function of the upper limb, evaluated by SSQOL, and its relation to oral health, evaluated by OHIP-14, it was possible to observe the statistically significant correlation in the domains of Physical Pain, Functional Limitation, Psychological Discomfort, Physical Incapacity, Social Incapacity, Social Disadvantage and Psychological Incapacity. In all the domains stated above, the correlations were negative. Regarding the electromyography, a statistical significant difference was observed during rest, in the intergroup evaluation, both on the right side (p=0.005) and on the left (p=0.005). A negative correlation was verified, of moderate magnitude (-0.643) (p=0.02), among the electromyographic signals at rest and the male individuals that did not present TMD in the complete hemiparetic group. As to the time of injury, a negative correlation was also observed, of moderate magnitude (-0.663) (p=0.00) between the time of injury and the electromyographic signal in individuals without TMD also in the complete hemiparetic group, which allowed us to complete the relation between the TMD, time of injury and EMG in hemiparetic individuals with stroke, except for bite force which did not show a relation with hemiparesis. Finally, the orofacial function needs to be better understood, because it aggregates immeasurable…

Submitted by Nadir Basilio ([email protected]) on 2016-05-24T20:58:42Z No. of bitstreams: 1 Fabiana Sobral Peixoto Souza.pdf: 974536 bytes, checksum: c2d1061af7b82ef311f02e54edfcd5bd (MD5)

Made available in DSpace on 2016-05-24T20:58:42Z (GMT). No. of bitstreams: 1 Fabiana Sobral Peixoto Souza.pdf: 974536 bytes, checksum: c2d1061af7b82ef311f02e54edfcd5bd (MD5) Previous issue date: 2014-12-09

Background: Obesity is a public health problem. The imbalance between pro- and anti-inflammatory mechanisms is responsible for chronic inflammation of low grade. Besides multiple morbidities associated with obesity, these individuals have respiratory dysfunction and changes in functional capacity which reflects the physical capacity. Objectives: To investigate the impact of weight loss induced by bariatric surgery in pulmonary function, respiratory muscle strength (RMS) and in systemic and pulmonary inflammatory markers of obese women without changes in pulmonary function; to evaluate the reproducibility of the incremental shuttle walk test (ISWT) in women with morbid obesity; to assess functional capacity and oxygen consumption through ISWT in women undergone bariatric surgery. Methods: Three studies were performed, two longitudinals and one cross in which morbid obesity women were evaluated. It were conducted anthropometric measurements and body composition, lung volume and capacity data, maximal respiratory pressures, dosages of systemic and pulmonary inflammatory markers and functional capacity evaluation. Results: After bariatric surgery, it were observed improviment of the lung function and reduction of the inflammatory markers in the blood and induced sputum. ISWT proved to be reproducible and reliable test in women with morbid obesity and after bariatric surgery. showing an increase in distance traveled, but not oxygen consumption (VO2 peak) assessed during the test. Conclusion: Women with morbid obesity, with no change in lung function, showed improved respiratory function and respiratory and systemic inflammatory markers after weight loss induced by bariatric surgery. The application of two tests in the population of morbidly obese appears to be unnecessary because it had an excellent reproducibility. The ISWT provided useful information on functional status and physical function after weight loss induced by bariatric surgery.

Contextualiza????o: A obesidade ?? considerada um problema de sa??de p??blica. O desequil??brio entre os mecanismos pr?? e anti-inflamat??rio ?? respons??vel pela inflama????o cr??nica de baixo grau. Al??m de v??rias morbidades associadas a obesidade, esses indiv??duos apresentam disfun????es respirat??rias e altera????o na capacidade funcional o que reflete na capacidade f??sica. Objetivos: investigar o impacto da perda de peso induzida pela cirurgia bari??trica: na fun????o pulmonar, na for??a muscular respirat??ria (FMR) e, nos marcadores inflamat??rios sist??micos e pulmonares, de mulheres obesas sem altera????o da fun????o pulmonar; avaliar a reprodutibilidade do incremental…

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Objectives : To evaluate inspiratory muscle strength and endurance in children and adolescents with cystic fibrosis (CF) in comparison with healthy subjects. Methods : This cross-sectional observational study evaluated CF patients (6 to 18 years old) and healthy subjects paired in a 1:2 proportion, for sex, age, height and weight. Spirometry, impulse oscillometry, plethysmography, manovacuometry and a protocol of inspiratory muscle endurance were performed. Data were analyzed using Student s t test and Pearson correlation coefficient. Results : Thirty four patients with CF were included in the study with a mean age of 12.6?2.9 years and twenty of them were boys (58.8%). The mean percentage of maximal inspiratory pressure (MIP%) was 118.5?25.8 and the endurance (percentage of MIP) was 60.9?13.3. Sixty eight healthy subjects were included and they presented a mean MIP% of 105.8?18.0 and an endurance of 65.3?12.3 of. CF patients had higher MIP% than healthy subjects and no significant difference in the endurance was shown. When restricting the analysis to CF patients without colonization by Pseudomonas aeruginosa and with forced expiratory volume in one second (FEV1) greater than 80% of predicted values, MIP% values were significantly higher and inspiratory muscle endurance was lower, in comparison with the control group. MIP correlated more significantly with forced vital capacity (r=0.44, p=0.01) and FEV1 (r=0.41, p=0.01), while endurance correlated better with total airway resistance (r=0.35, p=0.04) and with central airway resistance (r=0.48, p=0.04). Conclusion : Children and adolescents with CF present changes in inspiratory muscle strength and endurance that are associated differently with levels of pulmonary impairment. Furthermore, the significant strength associations are better related to pulmonary function parameters, while endurance is to airway resistance.

M?todos : Estudo observacional, transversal, em pacientes com FC (6 a 18 anos) e indiv?duos saud?veis pareados na propor??o de 1:2 por sexo, idade, altura e peso. Foram realizados espirometria, oscilometria de impulso, pletismografia, manovacuometria e protocolo de endurance muscular inspirat?ria. Para an?lise de dados utilizou-se os testes t de student e a correla??o linear de Pearson. Resultados : Foram inclu?dos 34 pacientes com FC, m?dia de idade de 14,0?2,7, sendo 20 pacientes (58,8%) do sexo masculino, com m?dia de press?o inspirat?ria m?xima percentual (PIMAX%) de 118,5?25,8 e de endurance (percentual da PIMAX) de 60,9?13,3. Tamb?m foram inclu?dos 68 indiv?duos saud?veis com m?dia de PIMAX% de 105,8?18,0 e de endurance de 65,3?12,3. Os pacientes com FC apresentaram maior PIMAX% do que os saud?veis e n?o apresentaram diferen?a significativa na endurance. Ao analisar separadamente os pacientes com FC sem coloniza??o por Pseudomonas aeruginosa e com volume…

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A deformidade dentofacial (DDF) pode ser definida como sendo a condi????o em que o esqueleto facial foge ?? normalidade anat??mica e funcional. De acordo com os diferentes tipos, as DDFs geram altera????es miofuncionais considerando-se cada padr??o de bases ??sseas. Objetivo: analisar e descrever como ocorrem as fun????es estomatogn??ticas de acordo com os diferentes tipos de DDFs, tendo como referencial a atividade el??trica muscular do masseter e do temporal anterior (TA) em rela????o ?? mastiga????o, independente de terem ou n??o diagn??stico de disfun????o temporomandibular (DTM). Metodologia: trata-se de um estudo descritivo, anal??tico e de car??ter transversal, envolvendo uma amostra de 50 indiv??duos portadores de DDF frente ao grupo controle (GC) constitu??do por 46 indiv??duos saud??veis. A coleta de dados aconteceu entre os meses de julho a setembro de 2013, e consistiu na realiza????o de tr??s etapas: a primeira foi a aplica????o do instrumento Crit??rios Diagn??sticos para DTM (RDC/TMD) a fim de diagnosticar a DTM; a segunda compreendeu a avalia????o miofuncional orofacial, mediante a aplica????o do protocolo MBGR, enquanto que na terceira foi realizada a aquisi????o dos registros eletromiogr??ficos. O protocolo estat??stico fundamentouse na an??lise descritiva dos dados. Resultados: todos os sujeitos portadores de DDF avaliados apresentaram altera????es na execu????o das fun????es estomatogn??ticas sendo que tais altera????es variaram de acordo com o tipo de DDF apresentada. N??o foi estabelecida rela????o alguma entre a DTM e as DDFs analisadas, uma vez que, apenas, 12 indiv??duos apresentaram diagn??stico de DTM. De acordo com a metodologia empregada, a m??dia da atividade el??trica (AE) dos m??sculos masseter e TA no grupo DDF revelou estar diminu??da quando comparada ?? m??dia atribu??da aos indiv??duos do GC, sendo considerada a contra????o isom??trica volunt??ria m??xima (CIVM) e a fun????o mastigat??ria, respectivamente. A AE muscular em CIVM e durante a mastiga????o revelou estar relacionada ao padr??o mastigat??rio. Conclus??o: os diferentes tipos de DDF est??o relacionados ??s altera????es detectadas no desempenho das fun????es estomatogn??ticas; em indiv??duos portadores de DDF a atividade el??trica do masseter e do temporal anterior em CIVM e na mastiga????o est?? diminu??da; independente de estarem alterados, os diferentes padr??es mastigat??rios est??o associados ?? atividade el??trica do masseter e do TA na CIVM e na mastiga????o.

Made available in DSpace on 2015-04-14T13:35:32Z (GMT). No. of bitstreams: 1 438586.pdf: 851444 bytes, checksum: 4403bec36e79f61219a752dde80a37db (MD5) Previous issue date: 2012-03-28

Introduction: Spasticity is an incapacitating condition resultant from central nervous system injury such as the cerebral vascular accident, commonly known as stroke (STK). It is usually associated with hypertony and with a reduction in skeletal muscle force production. This condition may generate imbalance between antagonistic muscles at the ankle joint, which can be evaluated by torque ratios (TR). Purpose: to compare the dorsiflexor/plantarflexor (DF/PF) torque ratios between a post-stroke hemiparetic spastic group (STK) and a healthy control group (CON) and to evaluate STK group functionality. Methods: an isokinetic dynamometer was used to obtain maximal PF and DF torques at an angular velocity of 60?/s of hemiparetic spastic subjetcs (59.7 ? 13.74 years of age) and twelve healthy subjects (59.0 ? 13.64 years of age). TR were obtained through the division between the maximal DF and maximal PF torques. The STK group had their functionality evaluated through the Berg Balance Scale (BBS), the Barthel Index (BI), and the Timed Up and Go test (TUG). A Mann Whitney U test was used for the within group (spastic x non-spastic limbs) and for the between group (spastic x control) comparisons of the scale results and TR, whereas an independent T-test was used for the between groups comparison of the anthropometric variables (p ≤0.05). Results: The within STK group comparison revealed higher TR in the spastic side compared to the non-spastic contralateral side (0,81?0,25 and 0,43?0,41 respectively; p=0.01). The inter-group comparison revealed that the TR of the spastic side of the STK group was higher compared to the dominant side of the CON group (0,81?0,25 and 0,30? 0,10 respectively; p≤0.01). No differences were observed for the TR between the non-spastic side of the STK group and the dominant side of the CON group (0,43?0,41 and 0,30? 0,10 respectively; p=0.56). In addition, no changes in functionality were observed in the STK patients. Discussion: These results indicate that both limbs of the STK group show muscle imbalance, which might be explained by the smaller PF torque in both limbs, resulting on an elevated TR. The elevated TR found in the CON group is probably related to the fact that all subjects were sedentary. The STK group showed normal values for functionality, suggesting that the time post injury and the spasticity degree probably influence the results of these scales. Conclusion: Muscle imbalance is present in both lower limbs of post-STK patients, although the TR are more affected in the spastic side.

Introdu??o: a espasticidade ? uma condi??o incapacitante decorrente de les?es do sistema nervoso central como o acidente vascular cerebral (AVC), podendo estar associada com a hipertonia e diminui??o da for?a nos m?sculos. Tal condi??o pode gerar desequil?brios entre as musculaturas da articula??o do…

Made available in DSpace on 2015-04-14T13:32:57Z (GMT). No. of bitstreams: 1 437894.pdf: 860608 bytes, checksum: 959e5f29761ace404c63333ec242952c (MD5) Previous issue date: 2012-03-15

The evaluation of respiratory muscle strength is a noninvasive and easily applicable method, used for the measurement of maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP). However, there are no reference values for children in preschool age, which makes it difficult to standardize the results and complicates the assessment of respiratory muscle function. Thus, the objective of present study was to generate reference values for respiratory muscle strength in healthy children and adolescents aged between three to twelve years old. Participants were recruited from three schools and selected after a respiratory disease questionnaire analysis and attainment of informed and written consent by parents or guardians. All participants included in the study had normal spirometry and measures of height and weight were performed in the same day. The evaluation of respiratory muscle strength was performed by a single examiner following the guidelines for pulmonary function tests. The association between MIP and MEP values with the potential predictive variables was analyzed using a multiple linear regression model. A total of 171 participants were selected and distributed evenly by age. The age, height, weight and FVC showed moderate to strong correlations with both respiratory pressures. However, the regression model showed that the height and weight were the best variables to predict MIP in both sexes and age and weight to predict MEP. The power of prediction (R2) ranged from 46 to 58%. The intraclass correlation coefficient was used in a subgroup and demonstrated an excellent reproducibility between tests. In conclusion, the results of present study demonstrate that the behavior of respiratory muscle strength in healthy preschool and school children can be explained by age, height and weight.

A avalia??o da for?a muscular respirat?ria ? um m?todo n?o invasivo e de f?cil aplicabilidade, utilizado para a mensura??o da press?o inspirat?ria m?xima (PIMAX) e da press?o expirat?ria m?xima (PEMAX). No entanto, ainda n?o existem valores de refer?ncia para crian?as em idade pr?-escolar, impossibilitando a normaliza??o dos resultados obtidos e dificultando a avalia??o da fun??o muscular respirat?ria. Assim, o objetivo deste estudo foi gerar valores de refer?ncia para a for?a muscular respirat?ria em crian?as e adolescentes saud?veis de tr?s a doze anos de idade. Os participantes foram recrutados atrav?s de tr?s escolas e selecionados ap?s an?lise do question?rio de doen?as respirat?rias e assinatura do termo de consentimento pelos pais ou respons?veis. Todos os participantes inclu?dos no estudo possu?am exame espirom?trico normal e medidas de peso e altura no dia da mensura??o. A avalia??o da for?a muscular respirat?ria foi realizada por um ?nico avaliador seguindo as diretrizes para testes de fun??o pulmonar. A associa??o…

Made available in DSpace on 2015-04-14T13:34:59Z (GMT). No. of bitstreams: 1 424910.pdf: 8819126 bytes, checksum: 343a796019090b4026f34fd8be325684 (MD5) Previous issue date: 2010-05-03

INTRODU??O: A popula??o mundial est? envelhecendo. No processo fisiol?gico do envelhecimento, a perda de massa (sarcopenia) e for?a muscular nos idosos ? respons?vel pela redu??o de mobilidade, aumento da incapacidade funcional e depend?ncia f?sica nesta popula??o. OBJETIVO: Este estudo teve como objetivo comparar os ganhos de for?a e massa muscular em idosos independentes em um protocolo de resist?ncia, utilizando cintas el?sticas (grupo 1) e pesos e caneleiras (grupo 2). PACIENTES E M?TODOS: Estudo experimental com delineamento longitudinal. A amostra do estudo foi constitu?da por 43 sujeitos. A aplica??o do protocolo foi executada na seguinte ordem: a) avalia??o inicial (medidas antropom?tricas, bioimped?ncia, caracter?sticas s?cio-demogr?ficas, h?bitos de vida, patologias, hereditariedade, medica??es, testes de for?a); b) per?odo de adapta??o neuromuscular; c) protocolos de resist?ncia visando ganho de for?a; d) avalia??o final. A amostra foi estratificada, randomicamente, em dois grupos: grupo 1 cintas el?sticas (n = 21) e grupo 2 halteres e caneleiras (n = 22). Adotou-se um n?vel de signific?ncia de 5%. As associa??es entre as vari?veis categ?ricas e o grupo de pesquisa foram analisadas por meio do Teste de Quadrado ou Exato de Fisher. As vari?veis quantitativas na condi??o inicial ou basal foram comparadas por meio do Teste t de Student. A ANOVA com medidas repetidas foi utilizada para comparar os resultados dos protocolos de resist?ncia nos dois momentos da investiga??o (inicial e final) entre os dois grupos. RESULTADOS: Os dois grupos foram homog?neos com rela??o ?s vari?veis de interesse da pesquisa na condi??o basal. Houve diferen?as significativas (p<0,05) entre os dois momentos do ensaio para as seguintes vari?veis: di?metro da coxa, cintura, dobras cut?neas, percentagem de gordura, percentagem de massa livre de gordura corporal, peso massa livre de gordura corporal, peso massa de gordura corporal, ?gua corporal, teste de sentar e levantar e teste de for?a de bra?o. N?o foram observadas diferen?as entre os resultados dos dois protocolos de resist?ncia. 8 CONCLUS?O: Os exerc?cios de resist?ncia, realizados com cintas el?sticas e pesos tradicionais, mostram-se eficazes na recupera??o da perda de massa muscular e no aumento da for?a muscular em idosos independentes.

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Introdu??o: O envelhecimento est? associado com a perda progressiva do desempenho do sistema ventilat?rio. A avalia??o da for?a da musculatura ventilat?ria ? importante para monitoramento das altera??es nas press?es ventilat?rias. No entanto, os valores de normalidade da press?o inspirat?ria m?xima (PIM) e da press?o expirat?ria m?xima (PEM) ainda s?o controversos na literatura. Objetivo: Verificar os valores da PIM e PEM em indiv?duos idosos. M?todos: A amostra foi definida atrav?s de um mapeamento distrital da cidade de Porto alegre, onde foram selecionados indiv?duos com idade igual ou superior a 60 anos, de forma randomizada, respeitando a proporcionalidade de cada regi?o. Foram inclu?dos neste estudo 509 indiv?duos, com idade igual ou superior a 60 anos, divididos em tr?s faixas et?rias, nos quais foram avaliados medidas de PIM e PEM atrav?s de manovacuometria. Resultados e conclus?es: os resultados indicam que as press?es ventilat?rias geradas pelos homens s?o maiores do que as mulheres nas tr?s faixas et?rias estudadas, que as press?es ventilat?rias apresentam correla??o negativa com a idade e que o efeito do aprendizado parece afetar mais mulheres do que os homens e apenas da primeira medida em rela??o ?s outras