Rozprawy doktorskie na temat „Posture”

In all the experiments we investigated the relationship between the voluntary movement and the postural control. We particularly focused our attention on the role played by the APAs, since the general hypothesis is that the postural feed forward control of the movement is strictly bound to the voluntary movement itself in a complex and flexible way. In the first experiment we tested the hypothesis that APAs preceding an upper-limb target reaching movement could play a role also in controlling the movement accuracy. The aim of this study was seeking a direct proof of the relationship between the APAs amplitude and the endpoint of a target reaching movement. The aim of the second study was to determine whether a short term immobilization (12 h) interferes in parallel with both the activation of the prime mover muscle, responsible for a given movement, and the postural muscles that are recruited to stabilize the limb. In the third experiment was aimed at verifying whether the postural activation is affected by the phenomenon of the motor resonance as well as already described for the prime mover activation. The results of the first experiment reinforce the hypothesis that a successful on-target pointing movement relies upon a specific tuning between APAs and prime mover activation, as that obtained at the end of the adaptation phase. The most important result of the second experiment is that, although the prime mover activation remains unchanged after the immobilization, the trajectory described by the index finger is most likely changed between the two sessions due to the modification in the postural control that led to a less effective stabilization of the proximal joint, as was suggested by the mechanical model designed by Caronni and Cavallari (2009a). In the last experiment we demonstrated that the resonant response in resting subjects replicates, under threshold, both the primary movement and postural activity. The precocious increase in excitability observed in BB may be the expression of the anticipatory activation observed during the execution of the movement. Given that MR reflects aspects that are intrinsic to motor programming also this result strongly support the idea that primary movement and the postural command are essential components of the same neural process.

La posture littéraire de Gide peut être considérée dans son rapport à la problématique du classicisme. Chez Gide, le classicisme relève de l’élaboration d’une morale et d’une esthétique personnelles, qui n’excluent pas complètement la doctrine historiquement définie. Mais le classique peut aussi dépasser tout historicisme et atteindre la hauteur du jugement absolu, de la valeur intemporelle. C’est sur ce point que la problématique du classique rejoint celle du jeu et de l’intention et que Gide s’impose comme une instance intentionnelle entre son œuvre et le lecteur, pour guider le lecteur dans son jeu d’écriture et pour élever son œuvre à l’intemporalité, au rang des classiques. L’étude présente, divisée en trois parties, se propose d’explorer la posture littéraire complexe de Gide : elle forme un système dynamique bâti autour de l’intention créatrice de l’auteur, qui se manifeste à travers le texte et se réalise avec la complicité du lecteur tout en fixant à l’œuvre l’objectif de devenir intemporelle
André Gide’s literary posture can be related to the problematic question of classicism. Gide considers the classicism as emanating from personal morals or aesthetics without excluding entirely the historical definition of the doctrine. At the same time, the classical can outdo historicism and reach the level of an absolute judgement, an everlasting value. Here precisely, the question of the classical is connected with the question of the play and the question of the intention: Gide appears as an intentional performer between his work and the reader in order to guide the reader in the game of his writing and to elevate his work to the rank of an everlasting classical. In the three parts of our thesis, we examine Gide’s intricate literary posture: this dynamic system is built around the creative intention of the author, the posture having to be discovered in the text itself and needing the reader’s complicity, in the hope of elaborating an everlasting work

L’objectif de ce travail est de déterminer l’influence des réductions de mobilité ostéo-articulaire passive et active sur la capacité posturo-cinétique. La réduction de mobilité passive est analysée à travers un mouvement d’élévation des membres supérieurs à vitesse maximale au cours duquel seront mesurés des indices électromyographiques (Tibial antérieur, Soléaire) et biomécaniques (plateforme de force, accéléromètre). La réduction de mobilité active est étudiée à partir d’un examen posturographique combiné à un mouvement de compression d’une barre dynamométrique et à l’enregistrement de la cinématique respiratoire. L’analyse de la composante passive révèle que, dès 50% de perte de mobilité au niveau de la région cervicale, la capacité posturo-cinétique (CPC) est perturbée. Le blocage passif des articulations des chevilles et du rachis cervical semble davantage réduire la CPC que celui des genoux ou du rachis lombaire. L’étude de la composante active montre que l'augmentation de la tension musculaire active le long du tronc est susceptible de perturber l'équilibre postural, mais uniquement lorsqu'elle dépasse un certain niveau. Ainsi les deux composantes, passive et active, de la mobilité ostéo-articulaire, paraissent chacune jouer un rôle dans la capacité à compenser les perturbations associées au maintien postural ou à l’exécution du mouvement
The aim of this study was to determine the influence of passive and active components of osteoarticular mobility on the capacity posturo-kinetic. The passive component was analyzed through a paradigm of upper limb elevation at maximum velocity, during which electromyographic (Tibialis anterior, soleus) and biomechanical (force platform, accelerometer) parameters were measured. The active component was studied from an experimental paradigm associating a posturaphic examination with a bimanual compression of a dynamometric bar. Results analysis showed that the posturo-kinetic capacity (PKC) was reduced when the loss of mobility exceeded 50% at the neck level. Passively blocking the ankle joints and the cervical spine seemed more likely to reduce the PKC than blocking the knee or the lumbar spine. The study of the active component showed that the increase in active muscle tension along the trunk may impair body balance, but only when it exceeds a certain level. Thus the two components, passive and active, of the osteoarticular mobility, appeared as significant factors in the ability to compensate for the disturbances associated with postural maintenance or movement execution

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Introduction: Several types of insoles are used to promote changes in body positioning and improve balance. The postural insoles are orthoses used to correcting or improving postural alignment, balance and weight bearing. Podal elements are used in this insoles, positioned in specific places to promote this correction. The immediate effects of the elements on posture are factors that define the prescription of the insoles. Objective: To carry out a systematic review of the literature about the effect of insoles on static balance and posture. We verified the immediate effects of the podal elements (infracapital and retrocalcanenus bar, calcaneus wedges and infracuboid element) on a posture, static balance and a weight bearing of healthy individuals. Methodology: The review was implemented in the Medline, PuMed, SciELO and Cochrane Library databases. Inclusion criteria of the studies: interventional studies with insoles, published from 2010 to 2016; measurement of postural variables and static balance; in Portuguese and English. Fifteen studies were selected. The experimental, controlled and randomized study included a sample composed of 60 healthy individuals divided by raffle in control group (30) and study group (30). The inclusion criteria were: individuals between 18 and 40 years of age of both genders without musculoskeletal pain complaints. The exclusion criteria were: reports of injuries or neurological diseases, vertigo or dizziness, pregnant women with spinal or foot surgeries, foot ulcers, amputation, visual impairment, who are using postural insoles, without girdles asymmetries and with discrepancy in the length of the lower limbs greater than 5 millimeters. Postural evaluation and static baropodometry and stabilometry were performed. From the postural changes, the podal elements were prescribed for the study group. Both underwent identical reassessment, in the study group with the elements under the feet. The Shapiro-Wilk normality test (S-W) was used and, from this test, parametric and non-parametric tests were used according to the variable. For the analysis of the posture the chi square test was used and for comparative analysis of baropodometry and stabilometry the Wilcoxon test was performed. Results: In the systematic review, we did not find a positive result of insoles on the posture, but the results indicated an improvement of the static balance with the use of insoles in individuals who already presented balance deficit. In the clinical trial, pelvic and scapular assimetries improved and the plantar pressure peak decreased (p <0.05). Conclusion: Although the results point to an improvement in the static balance, due to the wide variety of insoles and populations studied, it was not possible to establish a consensus in the systematic review. In the experimental study, the podal elements were able to improve the posture and distribution of plantar pressure. Positive effects on balance in normal subjects not be proved in this research, which may be due to the time of exposure to the stimulus and also to the characteristics of the sample.
Introdução: Diversas modalidades de palmilhas são utilizadas com o objetivo de promover mudanças no posicionamento corporal e melhorar o equilíbrio. As palmilhas posturais são órteses utilizadas com o propósito de corrigir ou melhorar o alinhamento postural, o equilíbrio e a descarga de peso. Peças podais são os relevos utilizados nessas palmilhas, posicionados em locais específicos com vistas a promover essa correção. Os efeitos imediatos das peças podais sobre a postura são fatores que definem a prescrição das palmilhas. Objetivo: Relizar uma revisão sistematizada da literatura sobre o efeito de palmilhas sobre o equilíbrio estático e a postura. Verificar os efeitos imediatos das peças podais (barra infracapital e retrocalcaneana, cunhas de calcâneo e elemento infracubóide) sobre a postura, equilíbrio estático e a descarga de peso plantar de indivíduos saudáveis. Metodologia: A Revisão sistematizada foi realizada nas bases de dados Medline, PuMed, SciELO e Biblioteca Cochrane. Os critérios de inclusão dos estudos foram: estudos intervencionistas com palmilhas, publicados de 2010 a 2016; medida de variáveis posturais e de equilíbrio estático; nos idiomas português e inglês. Foram selecionados 15 estudos. O estudo experimental, controlado e randomizado apresentou uma amostra composta de 60 indivíduos saudáveis divididos por sorteio em grupo controle (30) e grupo de estudo (30). Os critérios de inclusão foram: indivíduos entre 18 a 40 anos de idade de ambos os gêneros sem queixas álgicas musculoesqueléticas. Já os critérios de exclusão foram: relato de lesões ou doenças neurológicas, com vertigem ou tontura, gestantes, com cirurgias na coluna ou nos pés, úlceras nos pés, amputação de membros, deficiência visual, que estejam em tratamento com palmilhas posturais, sem assimetrias de cinturas e com discrepância no comprimento dos membros inferiores maior que 5 milímetros. Foi realizada avaliação postural e exame estático de baropodometria e estabilometria. A partir das alterações posturais foram prescritas as peças podais para o grupo de estudo. Ambos passaram por reavaliação idêntica, no grupo de estudo com as peças podais sob os pés. Foi usado o teste de normalidade de Shapiro-Wilk (S-W) e, a partir desse, testes paramétricos e não paramétricos foram escolhidos conforme a variável. Para análise da postura foi aplicado o Teste Qui-quadrado e para as análises comparativas da baropodometria e estabilometria foi realizado o teste t e/ou Wilcoxon. Resultados: Na revisão sistematizada, não foi encontrado resultado positivo de palmilhas sobre a postura, porém os resultados apontaram melhora do equilíbrio estático com o uso de palmilhas em indivíduos que já apresentam déficit de equilíbrio. No ensaio clínico, houve melhora das básculas e rotações de cintura pélvica e escapular e diminuição do pico de pressão plantar (p<0,05). Conclusão: Apesar dos resultados apontarem uma melhora do equilíbrio estático, devido a ampla variedade de palmilhas e de populações estudadas, não foi possível estabelecer um consenso sobre o tema na revisão sistemática. No estudo experimental as peças podais promoveram melhora da postura e da distribuição da pressão plantar. Efeitos positivos sobre o equilíbrio em indivíduos normais não puderam ser comprovados nessa pesquisa, o que pode ter sido em função do tempo de exposição ao estímulo e também às características da amostra.

ABSTRACT Postural deformities are a commonly encountered problem among children. Most of the aches and pains of adults are the result, not of injuries, but of the long-term effects of distortions in posture or alignment that have their origins in childhood or adolescence. Television, video entertainment, motorized transportation, fast food and lack of regular physical activity contribute to the poor physical condition of children. Childhood obesity has increased dramatically in the past decade. Countries in economic transition from underdeveloped to developed, such as South Africa, are particularly affected and have an increasing prevalence of obesity across all economic levels and age groups. In a developing country like South Africa, where overweight/obesity co-exists with undernutrition, there is an urgent need to prevent unhealthy trends in diet and physical activity. School screening is mandatory in schools in 26 states of the United States (US) for children between 10 and 16 years of age. Previous studies conducted in the US found that 160 out of 1000 people suffer from scoliosis (Boachie-Adjei & Lonner, 1996). This means that scoliosis is as prevalent as hypertension or diabetes mellitus. Identification of postural deformities at an early stage makes early treatment possible, which may, in future, prevent serious postural abnormalities. The aim of this review article is to define the concept of good posture, analyze normal postural development and postural deformities, and discuss some of the developmental factors affecting posture.

The relationship between approach, avoidance and congruent postures and the experience of rapport was investigated. Sixty undergraduate college students (30 male, 30 female) were interviewed by a therapist who displayed either approach postures, avoidance postures or who posture shared. The degree of rapport experienced by the 20 subjects in the three groups was compared. In addition, the subjects' behaviors were divided into four groups (n = 11, or 19) along two orthogonal dimensions (high and low congruency and immediacy) and the degree of rapport experienced by the four groups compared. No statistically significant results were found in either analysis. An attempt was made to control for three crucial external variables: the therapist's degree of eye contact and smiling, and the verbal content of the interviews. Directions for future research were discussed with a focus on naturalistic study in the future. A self report measure of rapport was developed called the Rapport Experience Test (RET). The RET was designed to assess the successful communication of accurate empathy, unconditional positive regard and emotional congruence.Measures of internal consistency (Chronbach alpha) and test-retest reliability were obtained. These measures suggest that the RET may be a useful device for further research. Face validity was discussed.

A consciência do corpo humano é pré-requisito para o desenvolvimento da mecânica corporal. A avaliação física do indivíduo é necessária para que se identifiquem condições que possam prejudicar a saúde e predispor o desenvolvimento de lesões e melhorar o desempenho físico dos atletas. Por esse motivo técnicos esportivos indicam, empiricamente, a utilização de placas oclusais para prática esportiva. Além disto, é sabido que o uso de dispositivos intra orais podem influenciar a postura e o equilíbrio corporal. O presente estudo teve como objetivo avaliar a influência do protetor bucal individualizado no equilíbrio, postura de cabeça, mandíbula e ombro de atletas que buscaram atendimento no Ambulatório de Odontologia do Esporte da FOUSP e relatar a percepção dos atletas quanto a possíveis alterações no equilíbrio, postura corporal e desempenho esportivo com o uso do dispositivo. Participaram da avaliação postural por fotogrametria 32 atletas. Para avaliação do equilíbrio participaram 33 atletas. 37 atletas retornaram o questionário de percepção do uso do protetor bucal. A utilização do protetor bucal individualizado teve influência significante na variável distância glabela mento (p=0,005) por aumentar a dimensão vertical de oclusão do indivíduo, porém teve efeito clínico considerado pequeno. Este aumento não resultou em alterações posturais da cabeça, sagitais da mandíbula e ombros. Na análise do equilíbrio, não ocorreram alterações significantes no deslocamento do centro de pressão e o efeito clínico da utilização do dispositivo foi considerado pequeno. Não foram percebidas alterações no equilíbrio e postura corporal pela maior parte dos atletas (75,68% e 70,28%, respectivamente). A utilização do protetor bucal individualizado causa nos indivíduos mais confiança e os atletas relataram sentir melhora do desempenho (70,28%) e facilidade em executar gestos esportivos (67,56%). Conclui-se que o uso de protetores bucais individualizados não altera a postura, não causa alterações importantes de equilíbrio corporal e que os atletas se sentem mais confiantes e com melhor desempenho esportivo.
The consciousness of the human body is a prerequisite to the development of mechanical body. The physical assessment of the individual is required for the identification of conditions that could harm the health and predispose the development of injuries and improve the performance of athletes. For this reason, sports technicians have, empirically, indicated the use of occlusal plates for sports. In addition, it is well known that using intraoral devices may influence the posture and body balance. This study aimed to evaluate the influence of the custom made mouthguard in balance, posture of head, jaw and shoulder of athletes who sought care at the Ambulatório de Odontologia do Esporte of FOUSP and report the perception of athletes for possible changes in balance, body posture and sports performance with the use of the equipment. Participated in the evaluation by postural photogrammetry 32 athletes. To evaluate the balance 33 athletes participated. 37 athletes returned the questionnaire of perception of the use of the custom made mouthguard. The use of this equipment cases had significant influence in the variable distance glabella (p = 0.005) to increase the vertical dimension of occlusion of the individual, but was considered to have a small clinical effect. This increase did not result in postural changes of head, jaw and shoulders. The analysis of the balance had no significant changes occurred in the shift of the center of pressure and the clinical effect of use of the device was considered small. Were not perceived changes in balance and body posture by most of athletes (75.68% and 70.28%, respectively). The use of custom made mouthguard cases in individuals more confidence and athletes reported feeling better performance (70.28%) and easily run sporting gestures (67.56%). It is concluded that the use of custommade mouthguard does not change the posture, does not cause important changes in body balance and that athletes feel more confident and better sports performance.

As palmilhas posturais são órteses plantares e foram desenvolvidas por Bourdiol um pouco antes de 1980. Seu princípio está fundamentado na ação de peças podais, as quais são chamadas de elementos, barras, cunhas e calços, que são colocados sob a pele e os músculos plantares, reprogramando a postura. Na avaliação postural são observadas as variáveis descritas no protocolo CNT (assimetria dos membros superiores, assimetria das cristas ilíacas, assimetrias das Espinhas Ilíacas Póstero- Superiores - EIPS, etc.). A postura corporal é descrita como um processo de inter-relacionamento relativo das partes do corpo, havendo equilíbrio entre os ossos, músculos, tendões e ligamentos, estruturas que sustentam e protegem o corpo contra agentes externos ou internos. O objetivo deste estudo foi verificar os efeitos das palmilhas posturais sobre a postura corporal de escolares. Os objetivos específicos foram descrever as características posturais dos participantes durante a utilização das palmilhas posturais e verificar as alterações da pressão plantar dos escolares, durante a utilização das palmilhas. Foram avaliados 6 alunos da 3° série do ensino fundamental da Rede Particular da cidade de Porto Alegre – RS, todos do sexo masculino. Para a coleta de dados foi utilizada a avaliação postural através do Programa computacional para avaliação postural (PCAP) e através de um baropodômetro eletrônico. Os escolares foram avaliados pelo protocolo CNT, e através desta avaliação foram definidas quais peças podais seriam utilizadas na confecção das palmilhas. Os escolares foram avaliados primeiramente sem usar as palmilhas posturais, e em seguida fazendo uso das palmilhas, para fins de comparação. Os resultados da avaliação postural demonstraram alterações na postura corporal dos escolares em relação ao protocolo CNT ao utilizar as palmilhas posturais. E os resultados obtidos através do teste de Wilcoxon, com o nível de significância de 5% apontaram diferença significativa na avaliação da pressão plantar na região posterior do pé esquerdo ao utilizar as palmilhas posturais. Conclui-se que a utilização das palmilhas posturais provoca alteração na postura corporal de escolares, e que a pressão plantar apresenta mudanças ao utilizar as palmilhas posturais, com diferença estatisticamente significativa na região posterior do pé esquerdo (p=0,028). As outras regiões do pé apresentaram uma melhor distribuição das pressões, porém seus dados não foram estatisticamente significativos.
Postural insoles are plantar orthosis developed by Bourdiol some time before 1980. Its principle is based on the action of podal pieces, which are called elements, bars, wedges and chocks that are placed under the skin and the plantar muscles, reprogramming the body posture. In postural evaluation, the variables described in CNT protocol are observed. The body posture is described as a process of relative inter-relationship of the body parts, balancing bones, muscles, tendons and ligaments, structures that support and protect the body against external or internal agents. The aim of this study was to verify the effect of postural insoles on the body posture of schoolchildren. The specific objectives had been to describe the postural characteristics of the subjects before and after the use of postural insoles and to verify the alterations on the plantar pressure of schoolchildren, before and after the use of the insoles. Six male pupils attending the third grade of elementary school from the city of Porto Alegre - RS had been evaluated. For the data collection, postural evaluation was analyzed through a computational program for postural evaluation (CPPE) and through an electronic baropodometer. The schoolchildren were evaluated by CNT protocol, and through this evaluation were defined which podal pieces would be used in the confection of the insoles. The schoolchildren had been first evaluated without the use of postural insoles, and after that making use of the insoles, for comparison reasons. The results of the postural evaluation demonstrate body posture alterations on schoolchildren when using the insoles. The results obtained through the Wilcoxon test, with 5% of significance, point statistical difference in the evaluation of the plantar pressure in the posterior region of the left foot when using the postural insoles. One can conclude that the use of postural insoles causes alteration in the body posture of schoolchildren. Also, that the plantar pressure presents changes when postural insoles are used, with statistical significance in the posterior region of the left foot (p=0,028). Other regions of the foot had presented a better pressure distribution, however its data had not been statistical significant.

Parmi toutes les informations sensorielles que le système nerveux central doit intégrer afin d'établir la commande musculaire permettant d'assurer une position debout, nous nous sommes plus particulièrement intéressés à ce qui est nommé le " toucher léger ". En effet, il a été montré que poser le doigt sur une surface fixe, même légèrement, fournissait une information supplémentaire permettant d'améliorer le contrôle postural. De manière intéressante, lorsque la surface est mise en mouvement, un couplage apparait entre ces mouvements et le balancement postural. Nous avons lors de nos travaux étudié comment cette information était intégrée au contrôle postural. En se basant sur les conclusions de cette étude, nous avons proposé une loi de commande en boucle fermée basée sur la modulation de la vitesse du doigt, qui permet de contrôler la position du centre de pression autour d'une consigne prédéfinie. Nous avons de plus étudié les conditions expérimentales pouvant affecter les performances de cette boucle fermée (instruction, conscience des mouvements du doigt, ajout/retrait d'un sens (la vision), action de rejet volontaire du couplage). Ces études nous permettent de proposer une explication exhaustive des mécanismes expliquant ce phénomène de couplage entre la posture et les mouvements du doigt. La loi de commande proposée permet de guider le centre de pression autour d'une consigne prédéfinie, tout en ne nécessitant ni la coopération ni la concentration des sujets, et présente ainsi un intérêt certain dans les domaines de l'assistance ou de la rééducation. Nous avons donc mené une étude préliminaire en milieu clinique démontrant le potentiel applicatif de cette dernière
Among the sensory information allowing to control postural balance, we have focused our research on Light Touch. Indeed, it has been shown that lightly touching a motionless surface, provides additional sensory information that improves balance. Interestingly, when the surface is moved slowly, a coupling appears between its motion and postural sway. We have investigated the mechanisms underlying this coupling. Based on our findings, we implemented a closed-loop control law, based on the modulation of the finger velocity, which allows to control the position of the center of pressure around a pre-defined trajectory. We also studied the experimental conditions that could influence the performance of the closed loop (instruction, awareness of finger movements, adding / removing a sensory inputs (vision), voluntary dismissal of action coupling). These studies allow us to offer a comprehensive explanation of the mechanisms underlying this phenomenon of coupling between the posture and movements of the finger. The proposed control law allows to guide the center of pressure around a pre-defined trajectory, without any cooperation from the participants. It could have an interest in the areas of assistance or rehabilitation as a new biofeedback. We therefore conducted a preliminary study in a clinical environment

A postura bípede reduz a área de apoio e demanda a atuação de um sistema de controle para manter o equilíbrio e a orientação dos segmentos corpóreos. A avaliação postural é muito importante nas intervenções fisioterapêuticas e a busca de sistemas confiáveis para avaliar a postura tem sido uma constante dentro da área. Nesta linha, a avaliação do equilíbrio sagital dado pela relação entre coluna lombar e pelve e pelo ângulo de incidência pélvica (IPE) tem sido usado para as alterações da coluna vertebral. Objetivo: fazer a mensuração dos parâmetros posturais pelo programa de avaliação postural (SAPO) e do equilíbrio sagital pelo programa Keops e fazer a correlação entre eles. Metodologia: foram avaliados 80 indivíduos saudáveis de ambos os sexos com idade entre 20 e 35 anos. Foi feita a biofotogrametria (marcação dos pontos anatômicos do indivíduo e fotografias com os marcadores) do programa SAPO. Foram utilizadas as variáveis obtidas nas vistas lateral esquerda e direita. As medidas dos parâmetros do equilíbrio sagital (ângulo de incidência pélvica é o mais relevante) foram obtidas pela análise de uma radiografia panorâmica em perfil da coluna vertebral, na qual se fazia a marcação digital de pontos anatômicos de referência. O cálculo dos ângulos era feito de forma automática pelo programa Keops. Resultados: pela avaliação do programa Keops: 17,5% dos indivíduos tinham ângulos de incidência pélvica altos ( > 60o), 51,2% tinham ângulos incidência pélvica médios (46-59o) e 31,5% tinham ângulos de incidência pélvica baixos ( < 45o). O SAPO mostrou 12,5% de lordose, 40% de retificação e 47,5% com curvatura normal. Na vista lateral direita, o ângulo de incidência pélvica teve correlação moderada e positiva com o alinhamento vertical do tronco e com o alinhamento vertical do corpo e negativa e moderada com o alinhamento horizontal da pelve. Na vista lateral esquerda o ângulo de incidência pélvica teve correlação fraca e negativa com o alinhamento horizontal da pelve. Não houve correlação entre os parâmetros avaliados pelo programa
Bipedal stance raises the center of mass, reduces the support area, and demands action of the postural control system, which maintains balance and orientation of body segments. Postural alterations may affect the control system, causing pain and motor dysfunctions. Postural assessment is fundamental for therapy recommendation, and some parameters related to the sagittal balance of the lumbar spine and pelvis, like the pelvic incidence angle (PI), have been studied in alterations of the spine. The goal of this study is to assess and look for correlations between postural measurements, with photographs marked in anatomical points, through the Postural Assessment Program (SAPO), and radiographic assessment of the spine to analyze the pelvic incidence angle (PI), using of the computer software Keops. Casuistry and methods: eighty-one healthy individuals of both sexes, aged between twenty and thirty-five were evaluated. Results: in the Keops assessment, 17.5 % of the sample had high pelvic incidence angles ( > 60o), 31.5 % had low pelvic incidence angles ( < 45o), and 51.2 % had medium pelvic incidence angles (between 46o and 59o). SAPO showed 12,5% of lordosis , 40% of retroversion and 47,5% normal curvature.In the right lateral view, the pelvic incidence angle had a moderate and positive correlation with the vertical alignment of the trunk and with the vertical alignment of the body and negative and moderate with the horizontal alignment of the pelvis. In the left lateral view the pelvic incidence angle had a weak and negative correlation with the horizontal alignment of the pelvis. There was no correlation between the parameters evaluated by the Keops program

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior
Neck pain has been considered a costly musculoskeletal problem, with impacts on health and quality of life of individuals may be related to repetitive strain and maintenance of postures. These changes cause mechanical and nociceptive disorders of the neck region may cause balance disorders. Maintenance of postural balance occurs through the action of the postural control system, any compromise of this system can lead to body imbalance. The dissertation was divided into two research papers, with different objectives. The first aim was to evaluate the influence of neck pain in women of postural control and verify the relation between pain and the possible changes in sensory systems and body posture and in the second, to investigate the correlation between the intensity of pain, head posture and postural sway. Neck pain group was composed of women, aged between 20 and 50, with neck pain for more than three months and the control group of women without neck pain. For characterization of the groups used interview, neck disability index (NDI) and Visual Analogue Scale. Postural balance was assessed by a force platform with acquisition frequency of 100 Hz. Postural balance with manipulation of the sensory systems was evaluated by Dynamic Posturography Foam-laser. Posture was assessed by the Postural Assessment Software in the sagittal plane right. Normality of variables was checked by Shapiro-Wilk test, and Student t test and Mann Whitney test for comparison between groups. The relationship between variables was assessed by Spearman correlation test. Significance level of 5%. Groups were homogeneous in date demographics. Variables of postural balance showed higher amplitude and velocity of displacement of the center of pressure in the neck pain group, showing greater postural sway in this group. There were significant differences in craniovertebral angle, being lower in symptomatic women, showing forward head posture. In dynamic posturography difference was observed between the groups and the score obtained by the group with neck pain in the six sensory conditions showed that postural balance showed greater impairment. Neck pain and forward head posture have a deleterious effect on postural control in symptomatic women. Pain intensity correlated with the COP sway area and the craniovertebral angle indicating that women with cervical pain had forward head posture associated with a lower postural control.
A dor cervical vem sendo considerada um oneroso problema osteomuscular, com impacto sobre a saúde e qualidade de vida dos indivíduos podendo estar relacionada aos esforços repetitivos e a manutenção de posturas inadequadas. Essas alterações provocam transtornos mecânicos e nociceptivos na região cervical, podendo causar distúrbios do equilíbrio. A manutenção do equilíbrio postural ocorre por meio da atuação do sistema de controle postural e qualquer comprometimento desse sistema pode dar origem ao desequilíbrio corporal. A dissertação foi dividida em dois artigos de pesquisa, com objetivos distintos. No primeiro objetivamos avaliar a influência da dor cervical no controle postural de mulheres e verificar a relação da dor com as possíveis alterações nos sistemas sensoriais e postura corporal e, no segundo, investigar a correlação entre a intensidade da dor, postura da cabeça e oscilação postural. O grupo dor cervical foi composto por mulheres, entre 20 e 50 anos, com dor cervical por mais de três meses e o grupo controle por mulheres sem dor cervical. Para caracterização dos grupos utilizou-se ficha de anamnese, índice de incapacidade cervical (NDI) e Escala Visual Analógica. O equilíbrio postural foi avaliado por uma plataforma de força com fequência de aquisição de 100 Hz. O equilíbrio postural com a manipulação dos sistemas sensoriais foi avaliado pela posturografia dinâmica Foam-laser. A postura foi avaliada pelo Software de Avaliação Postural no plano sagital direito. A normalidade das variáveis foi verificada pelo teste de Shapiro Wilk, e os testes t-student e Mann Whitney para comparação entre grupos. A relação entre as variáveis foi verificada pelo teste de correlação de Sperman. Nível de significância de 5%. Os grupos apresentaram homogeneidade nas variáveis demográficas. Nas variáveis de equilíbrio postural observou-se maior amplitude e velocidade de deslocamento do centro de pressão no grupo dor cervical, demonstrando maior oscilação postural neste grupo. Houve diferença significativa no ângulo craniovertebral, sendo menor nas mulheres sintomáticas, mostrando anteriorização da cabeça. Na posturografia dinâmica observou-se diferença entre os grupos e o escore obtido pelo grupo dor cervical nas seis condições sensoriais demonstrou que o equilíbrio postural apresentou maior comprometimento. A dor cervical e a postura anteriorizada da cabeça têm efeito deletério no controle postural de mulheres sintomáticas. A intensidade da dor apresentou correlação com a área da elipse e com o ângulo craniovertebral indicando que as mulheres com dor cervical apresentaram postura anteriorizada da cabeça associada a um menor controle postural.

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Postural alterations are considered a problem of Public Health. On the other hand, the number of people who join physical training programs to increase their physical performance has increased. However, many of them may have postural alterations, which they are not aware of. The aim of this research was to verify the predominance of postural alterations of the spine column regarding age, sex, pain complaints and postural habits in people who are joining sports activities. The study is a research of epidemiologic nature, which describes and analyses in quantity terms, through a retrospective analysis of information derived from the database of a centre of sports training, situated in Goiânia, GO, where classes of sports training are taught. We analysed 720 files of students who were joining sports practice, of both sexes and age range from 20 to 50 years old. About 86.3% of the people joining physical activities showed some postural alterations and 80.30% felt some pain. The main postural alterations were caused by cervical hyperlordosis, followed by hypercifosis, low back hyperlodosis, as well as right and left convex escoliosis. Among the individuals who were evaluated , more than half presented cervical hyperlordosis. We noticed that cervical hyperlordosis was predominant in the age range from 35 to 50 years old. Low back hyperlodosis was more present from 40 to 50 years old. About 50% of the people evaluated showed hypercifosis and the age range more susceptible to it was from 35 to 50 years old. Right convex escoliosis was present among individuals from 40 to 50 years old. Women showed more postural alterations than men. We have seen that, regardless age range, most of the people joining physical activities presented spinal aches. We have also noticed that, most of them are not careful about their posture. Once we verified that most people joining physical activities have postural alterations, we suggested that, before starting any physical training, an adequate postural evaluation has to be made, in order to avoid possible discomfort, lesions and osteo y articular excessive demand. Besides, through our results, we can suggest that social programs related to postural health be created, which encourage correct postural habits.
As alterações posturais são consideradas um problema de saúde pública. Por outro lado, têm aumentado o número de indivíduos que ingressam em programas de treinamento físico com o objetivo de aumentar o desempenho físico. Entretanto, muitas destes podem ter alterações posturais, as quais desconhecem. O objetivo deste trabalho foi verificar a predominância de alterações posturais da coluna vertebral com relação à idade, sexo, queixas álgicas e hábitos posturais em ingressantes na prática esportiva. O estudo trata de uma pesquisa de natureza epidemiológica, de cunho descritivo analítico em termos quantitativos por meio de uma análise retrospectiva de informações provenientes do banco de dados de um centro de treinamento esportivo, localizado em Goiânia-GO, onde são ministradas aulas de treinamento esportivo. Foram analisadas 720 fichas dos ingressantes na prática esportiva de ambos os sexos e faixa etária de idade compreendida de 20 a 50 anos. Cerca de 86,3 % dos indivíduos ingressantes em treinamentos esportivos apresentam alterações posturais e 80,3 % relatam sentir algias. As principais alterações posturais foram a hiperlordose cervical, seguida da hipercifose, hiperlordose lombar e escoliose destro e sinistro convexa. Do total de indivíduos avaliados mais da metade apresentam hiperlordose cervical. Observou-se que a hiperlordose cervical predominou na faixa etária dos 35 a 50 anos. A hiperlordose lombar foi maior dos 40 aos 50 anos. Cerca de 50% dos avaliados apresentam hipercifose e a faixa etária mais acometida foi dos 35 aos 50 anos. A escoliose destra convexa foi presente nos indivíduos de 40 a 50 anos. O sexo feminino apresentou mais alterações posturais que o masculino. Observou-se que independente da faixa etária a maioria dos ingressantes apresentaram queixas álgicas na coluna vertebral. Observou se também que a maioria dos ingressantes na prática esportiva não tem cuidados com a postura. Uma vez que foi verificado que a maioria dos ingressantes na prática esportiva apresentaram alterações posturais, sugere-se que antes de iniciar qualquer treinamento físico seja realizada uma avaliação postural adequada para evitar possíveis desconfortos, lesões e sobrecargas ostemioarticulares. Além disso, por meio dos resultados pode-se sugerir que sejam criados programas sociais direcionados à saúde postural, que estimule os hábitos de postura corretos.

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A coluna vertebral é localizada na porção posterior e mediana do tronco. É constituída por 33 vertebras (7 cervicais, 12 torácicas, 5 lombares, 5 sacrais e 4 coccígeas). Na postura ereta o homem apresenta curvaturas que são fundamentais para a biomecânica da coluna (lordose cervical, cifose torácica, lordose lombar e cifose sacral). O joelho é articulação mediana do membro inferior mais complexa em termos biomecânicos e uma das simples em termos funcionais, composta pelos ossos: fêmur, tíbia, fíbula e patela. O pé é composto por 26 ossos e é dividido anatomicamente em três seguimentos: Retropé; mediopé; antepé. A postura correta é a posição na qual um mínimo de estresse é aplicado em cada articulação. As alterações posturais são definidas como sendo o resultado das forças contrárias que agem nas superfícies articulares e pelo excesso de solicitação dos músculos e ligamentos, uma vez que a postura não é regida apenas por um músculo isolado e sim por conjunto de músculos, logo depende da harmonia dos mesmos. A avaliação postural é um passo muito importante para o tratamento fisioterapêutico, pois a partir desta avaliação constrói-se o diagnóstico cinesiológico e direcionam-se as condutas terapêuticas. A Biofotogrametria constitui-se como método simples, de baixo custo, pouco tempo de aplicação, fácil fotointerpretação, alta reprodutibilidade, sem radiação e pode ser aplicado diversas vezes ao longo do crescimento do indivíduo. Não consiste num meio de diagnóstico, mas apresenta-se como método útil na análise de assimetrias posturais.
The spinal column is located on the rear and middle trunk portion. It consists of 33 vertebrae (7 cervical, 12 thoracic, 5 lumbar, 5 sacral and 4 coccygeal). In upright posture the man has curvatures that are critical to the biomechanics of the spine (cervical lordosis, thoracic kyphosis, lumbar lordosis and sacral kyphosis). The knee is middle joint of the more complex lower extremity biomechanics in terms of simple and functional terms, composed of bones: the femur, tibia, fibula and patella. The foot consists of 26 bones and is divided anatomically into three segments: Rearfoot; midfoot; forefoot. The correct posture is the position in which a minimum stress is applied to each joint. The postural changes are defined as the result of the opposing forces acting on the joint surfaces and the excess request of muscles and ligaments, since the position is not governed by only one isolated muscle but by set of muscles, then depends on the harmony thereof. Postural assessment is a very important step for physical therapy, because from this evaluation builds up the kinesiological diagnosis and guide to the therapeutic procedures. The photogrammetry is constituted as simple, low cost, little time of application, easy photo interpretation, high reproducibility, no radiation and can be applied several times throughout the individual's growth. There is a means of diagnosis, but is presented as useful method for analysis of postural asymmetries.

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)
A postura sentada promovo diversas alterações nas estruturas músculo-esquelética, na circulação dos membros inferiores e no conforto dos membros superiores. Tais alterações produzem consequencias no processo de ensino-aprendizagem no âmbito escolar. Esta pesquisa buscou investigar os efeitos do procedimento de Reforço de Verbalização (RV) e Treino de Correspondência (TC) sobre a postura sentada em escolares e sobre seus relatos acerca dos posicionamentos dos pés, coluna lombar, coluna cervical e antebraços em três sequencias (Dizer-Fazer, Fazer-Dizer e Dizer-Fazer-Dizer). Participaram do estudo 9 alunos do 4º ano do ensino fundamental de uma escola pública do estado de São Paulo, com alturas semelhantes, que foram divididos em três grupos: Dizer-Fazer, (DF), Fazer-Dizer, (FD) e Dizer-Fazer-Dizer (DFD) com três alunos em cada grupo. O procedimento experimental compreendeu 4 condições experimentais: Linha de Base 1, Reforço de Verbalização (as respostas verbais corretas emitidas pelos participantes eram consequenciadas positivamente pela pesquisadora), Treino de Correspondência (a emissão das respostas verbais e dos posicionamentos corretos dos participantes eram consequenciados positivamente) e Linha de Base 2. Para verificar a correspondência entre o comportamento verbal e o não-verbal foi analisada a frequencia das respostas verbais corretas apresentadas pelos alunos em relação aos registros dos posicionamentos apresentados em relação a cada segmento corporal selecionado. Durante a Fase RV a frequencia da verbalização correta aumentou para todos os participantes dos três grupos, e os posicionamentos dos segmentos corporais pés e coluna lombar aumentaram para os participantes dos grupos DF e FD.
The sitting posture promotes several changes in the musculoskeletal structures, the movement of the lower limbs and in the comfort of the upper limbs. These effects have consequences in the teaching and learning in schools. This research investigates the effects of the procedure Boost Verbosity (VR) training and correspondence (TC) on sitting posture in children and about his statement regarding the positions of the feet, spine, cervical spine and forearm in three sequences (say-Do, Do-say and Do-Say-Say). Study participants were nine students in the 4th grade of elementary education at a public school in the state of Sao Paulo, with similar heights, which were divided into three groups: Say-Do, (DF), Do-Tell (FD) and Say-Do-Telling (DFD) with three students in each group. The experimental prodedure consisted of four experimental conditions: baseline 1, Strengthening of verbalization (the correct verbal responses issued by the participants were positive consequences for the researcher), Correspondence Training (the emission of verbal responses and the correct positioning of the participants were positive consequences) and Baseline 2. To verify the correspondence between the verbal and nonverbal analyzed the frequency of correct verbal responses made by students in relation to records of the positions presented in relation to each body segment selected. During Phase RV verbalization correct frequency increased for all three groups of participants, and positions of body segments, Iegs and lumbar spine increased for participants in the FD groups. In Phase CT correct verbalization was maintained by all participants of all groups and increased the correct position all body segments and hence the correspondence between the verbal and nonverbal behavior. In LB2 correct verbalization was maintained in all groups and there was a small decrease in matching segments of the cervical spine for all groups and for groups of forearms and DF DFD.

Durante a postura ereta quieta (PEQ) há oscilações aleatórias do centro de pressão, que podem ser medidas por uma plataforma de força. Esse movimento aleatório, que ocorre mesmo durante uma posição ortostática, é devido a fontes de variabilidade que vão desde a periferia do sistema sensorial até o sistema muscular na geração de torques, passando pelo sistema nervoso central. Uma vez gerados os comandos motores descendentes pelo encéfalo, fontes de variabilidade geradas na medula espinhal e nas unidades motoras contribuem para variabilidade na força desenvolvida e que não estão contidas nos comandos descendentes. O foco desta tese foi dirigido ao estudo da contribuição de fontes associadas à medula espinhal e às unidades motoras na geração de variabilidades do torque na articulação do tornozelo associadas ao controle do grupo muscular tríceps sural, que é de grande importância no controle da postura ortostática. A metodologia desenvolvida constou no estudo da variabilidade do torque de flexão plantar gerado em diferentes condições juntamente com a análise dos eletromiogramas dos músculos que compõem o tríceps sural. Foram realizados três conjuntos de experimentos: 1) sujeito sentado, com joelho estendido (JE) e joelho flexionado (JF) em tarefa de contração isométrica (tarefa de força - TF); 2) sujeito sentado, com joelho estendido, comparando TF com tarefa de controle de posição (TP); 3) sujeito em posição ortostática livre e apoiada, comparada com TF e TP executadas na posição sentada com o joelho estendido, na manutenção do mesmo torque de flexão plantar mensurado na posição ortostática. Essas últimas condições foram também testadas por meio do reflexo H do músculo SO. Para os experimentos 1 e 2 a amostra constou de 13 sujeitos e para o experimento 3 de 9 sujeitos, todos saudáveis. Os quantificadores utilizados para caracterizar os sinais captados foram o valor médio (), o desvio padrão () e o coeficiente de variação (CV), para os sinais de torque e da envoltória do eletromiograma (EMG) dos músculos sóleo (SO), gastronêmio lateral (GL) e gastronêmio medial (GM) nas condições acima. Os resultados do Experimento 1 são sintetizados a seguir. O torque em contração voluntária máxima (CVM) foi 58% maior na posição JE quando comparado com o valor em JF, mas a variabilidade ( e CV) foi maior em JF do que em JE. Para contrações de 10 a 80% da CVM, a variabilidade do torque ( e CV) também foi maior na posição JF do que na JE. Foi observada relação linear entre e do torque gerado pelo tríceps sural em JE e JF ( e normalizados em relação aos respectivos torques em CVM), aumentando a variabilidade da força gerada ao aumentar o valor médio da força. Os níveis de ativação muscular ( da envoltória) foram maiores em JE do que em JF, principalmente devido à maior ativação de GM e GL. O músculo SO apresentou intensidade de ativação normalizada maior do que a do GM e GL, tanto em JE quanto em JF. Tanto a intensidade do EMG quanto o da envoltória do EMG aumentaram com o valor do torque de flexão plantar exercido, para os três músculos que compõe o tríceps sural. No Experimento 2 foram obtidos os resultados descritos a seguir. A variabilidade do torque ( e CV) foi menor em TP do que em TF. Houve uma relação crescente entre o e o do torque gerado pelo tríceps sural, e entre o e o das envoltórias dos EMG dos três músculos em função do do torque 8 gerado pelo tríceps sural, em ambas as tarefas TF e TP. O da envoltória do EMG mostrou correlação positiva em relação ao do torque de flexão plantar, ambos normalizados em relação aos respectivos valores em CVM. Os resultados do Experimento 3 são sintetizados a seguir. A variabilidade do torque ( e CV) de flexão plantar durante a PEQ foi maior do que nas demais condições, havendo na amostra de sujeitos uma correlação positiva entre os valores de em PEQ e em TF ou TP. Por outro lado, em postura ereta apoiada (PEA), o do torque apresentou correlação nula com o do torque em TF ou TP. Os níveis de ativação muscular no tríceps sural foram maiores em TF do que nas demais condições, em grande parte devido ao nível de ativação do músculo SO em TF ter sido maior do que nas demais condições. O da envoltória do EMG dos músculos SO e GM variaram com as condições analisadas e o CV da envoltória do GM foi maior em PEQ do que nas demais condições. Não houve diferenças significativas no e no CV das amplitudes do reflexo H nas diferentes condições. Os resultados no geral podem sugerir que: i há uma otimização do controle neuromuscular na posição JE quanto comparado com JF no sentido de haver menor variabilidade do torque de flexão plantar em JE do que em JF para uma larga gama de forças; ii o grau de recrutamento relativo dos três músculos do tríceps sural é sensível ao ângulo articular no joelho (pelo menos entre 90º e 180º); iii o músculo SO é o mais ativado no tríceps sural, tanto em JE quanto em JF, para todos os níveis de torque analisados; iv na TP há menor variabilidade no torque de flexão plantar do que na TF, possivelmente devido à ação de diferentes proprioceptores, não se espelhando, entretanto, em diferenças nos graus de ativação ou de variabilidade das envoltórias dos EMGs dos três músculos do tríceps sural; v a variabilidade de torque em PEQ é maior do que nas demais condições, em PEA e TF são equivalentes, mas maiores do que em TP; vi um sujeito com maior variabilidade em TF ou TP apresentaria maior variabilidade em PEQ (como apresentado na análise de correlação), sugerindo que uma fração da variabilidade em PEQ é devida a fatores medulares e neuromusculares; vii em TF houve maior ativação do SO do que nas demais condições (PEQ, PEA e TP), que deve ser uma estratégia do sistema nervoso em face dos diferentes desafios postos pelas diferentes tarefas; viii de forma geral, a amplitude do reflexo H por si, não parece ser um indicador sensível dos diferentes eventos neurais ocorrendo na medula espinhal durante as várias condições experimentais PEQ, PEA, TF e TP
Random oscillations of the center of pressure are an inevitable feature associated with quiet standing (PEQ). This random movement may be attributed to different sources of variability including the sensory inputs at the periphery, the central nervous system and the neuromuscular system that generates the torques. Once the descending commands are generated by the brain, there are sources at the spinal cord and at the motor units that contribute with an added variability to the force generated by synergist muscles acting around a joint. These sources of force variability (generated at the spinal cord and at the motor units) were the focus of the present research, with a specific emphasis on the ankle joint and the triceps surae muscle group, which are directly involved in postural control during PEQ. The methodology consisted in studying the plantarflexion torque variability generated in different conditions together with the analyses of the electromyograms (EMGs) of the three triceps surae muscles. Three sets of experiments were used in the research: 1) subject seated, with either extended knee (JE) or flexed knee (JF), executing isometric contractions; 2) subject seated, with extended knee, comparing force task (isometric contraction, with force control TF) with position task (non-isometric force generation with position control TP); 3) subject standing, either naturally (PEQ) or attached to a fixed structure (PEA), compared with TF and TP exerted while seated, with JE, and with same torque as during PEQ. These conditions were also tested with the soleus H reflex. For experiments 1 and 2 the number of subjects was 13, while for experiment 3 it was 9, all healthy. The quantifiers that were used to characterize the signals were the mean value (), the standard deviation () and the coefficient of variation (CV). These were applied to the torque signal and for the EMG envelope of the muscles soleus (SO), lateral gastrocnemius (GL) and medial gastrocnemius (GM). The results of Experiment 1 are synthesized in what follows. The torque during maximal contraction (CVM) was 58% higher in JE as compared with JF, but the variability ( and CV) was higher in JF than in JE. The variability was also higher in JF for torque levels in the range 10 to 80% CVM. There was a linearly increasing relation between and of the torque generated by the triceps surae in JE and JF ( and normalized with respect to the respective CVMs). The levels of muscle activation (envelope ) were higher in JE than in JF, mainly due to the higher activation of GM and GL in JE when compared with JF. The SO muscle was more activated than GM and GL, both in JE and JF. Both the EMG level and envelope increased as a function of the plantarflexion torque, for SO, GL and GM. The results for Experiment 2 are described in what follows. Torque variability ( e CV) was lower in TP than in TF. There was an increasing relation between and of the torque generated by the triceps surae, and between and of the EMG envelopes of the three muscles as a function of the plantarflexion torque , during TF and TP. The EMG envelope was positively correlated with the plantarflexion torque , both normalized with respect to the respective values at CVM. The results of Experiment 3 are summarized in what follows. Plantarflexion torque variability ( e CV) during PEQ was higher than in the other conditions, the subject sample showing a positive correlation between torque in PEQ and in TF or TP. On the other hand, during 10 PEA, torque was uncorrelated with torque measured in TF and TP. The muscle activation levels in triceps surae were higher in TF than in the other conditions, mainly due to the higher SO activation in TF as compared with the other conditions. The EMG envelope of SO and GM varied with the conditions analyzed, and the GM envelope CV was higher in PEQ than in the other conditions. There were no statistical differences in the values of and CV of the H reflex amplitudes in the different conditions. The results in general may suggest the following: i there is an optimization of the neuromuscular control in position JE with respect to that in JF from the point of view that a lower variability of plantarflexion torque occurs in JE than in JF for a wide force range; ii the relative level of recruitment among the three muscles is sensitive to the knee angle (at least at 90º and 0o); iii the SO muscle is the most activated in the triceps surae, both in JE and JF, for all torque levels analyzed; iv there is less variability in plantarflexion torque in TP than in TF, perhaps due to the action of different proprioceptors, but without significant difference in muscle activation or EMG envelope variability between the two conditions; v plantarflexion torque variability in PEQ is higher than in the other conditions, being similar in PEA and TF and in TP being the smallest of all; vi a subject with a higher torque variability in TF or TP will present a higher variability in PEQ (as suggested by correlation analysis), suggesting that a fraction of the variability in PEQ originates in the spinal cord and neuromuscular system; vii the SO was more activated in TF than in the other conditions (PEQ, PEA and TP), which could be a strategy of the central nervous system to cope with the different tasks; viii in a general sense, the H reflex amplitude does not seem to be a sensitive indicator of the different neural events occurring in the spinal cord during the different experimental conditions (PEQ, PEA, TF and TP)

O presente estudo investigou as mudanças relacionadas à idade nos ajustes posturais compensatórios em crianças com e sem Desordem Coordenativa Desenvolvimental (DCD). Os ajustes posturais compensatórios foram investigados em 105 crianças (5-12 anos de idade) que foram selecionadas a partir de 538 crianças no sul do Brasil. As crianças com DCD foram definidas como aquelas com escores abaixo do 5º percentil no Teste Movement ABC. As crianças com desenvolvimento típico (DT) foram aquelas cujos escores no teste foram acima do 30º percentil (52 crianças). Os sujeitos foram solicitados a permanecerem em pé ereto sobre uma plataforma de força e a executar um movimento rápido alvo direcionado com o membro superior direito. O tempo de movimento e os erros absolutos do movimento do braço e também a amplitude e direção das mudanças do centro de pressão foram mensuradas. O resultado mostrou mudanças relacionadas à idade nos ajustes posturais compensatórios e, tempo de movimento, significativos em ambos os grupos. As crianças com DT mostraram mudanças com a idade significativas sobre a direção e amplitude do centro de pressão (COPy), sugerindo que eles melhoram suas habilidades para ajustar o equilíbrio quando realizando um movimento voluntário do membro superior com a idade, pelo uso do seu feedback. Crianças com DCD mostraram grandes amplitudes médio-laterais e tempo de movimento, quando comparadas com as crianças com DT. Uma correlação forte e positiva foi encontrada entre a amplitude do centro de pressão e o tempo de movimento em crianças com DCD sugerindo que os atrasos no movimento, frequentemente observados na criança com DCD, poderia ser causada por déficits posturais. Nós concluímos que a tendência desenvolvimental dos ajustes posturais compensatórios nas crianças com DCD é semelhante à criança com DT.
The present study investigated age-related changes of compensatory postural adjustments in children with and without Developmental Coordination Disorder (DCD). Compensatory postural adjustments were investigated in 105 children (5-12 years old) screened from 538 children in the south of Brazil. Children with DCD were defined as those with scores at or below the 5th (53 Children) percentile on Movement ABC Test. Typically developing children (TD) were those whose scores on the test were above the 30th percentile (52 children). Subjects were asked to stand upright and still on the force platform and perform a quick goal movement directed with the right superior limb. Movement time and absolute error of the arm movement and also amplitude and direction changes of the center of pressure were measured. The results showed significant age-related changes in the compensatory postural adjustments and movement time in both groups. TD children showed significant age-related changes on direction and amplitude of center of pressure (COPy), suggesting that they improve their ability to adjust their balance when performing an arm voluntary movements with the age by using their feedback. Children with DCD showed larger medium-lateral amplitudes and movement times as compared with TD children. A positive and well correlation found between center of pressure amplitude and movement time in children with CD suggests that the movements delays, often observed in children with DCD, could be caused by postural deficits. We conclude that the development trend of compensatory postural adjustments in children with DCD is similar to TD children.

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Introduction: Parkinson's disease (PD), a degenerative nature, idiopathic, features: resting tremor, muscle rigidity, weakness of spontaneous movements, gait, posture flexor, impaired balance, postural changes and instabilities, disability alignment body changes and postural control. For postural assessment we can make use of photogrammetry through Software postural assessment (SAPO). It consists of record photographs of the whole body in different postures plans and providing analysis of the position of anatomical landmarks of the body segments. The present study used the SAPO, understanding be another tool for everyday in the field of postural analysis combining thus the scientific and clinical environments. Objectives: To evaluate the alignment of posture and postural control in patients with Parkinson's disease, aged between 60 and 80 years; identify and quantify the positioning of body segments in the upright posture in frontal, rear, right side and left side. Methods: in this study, 50 individuals with PD, aged 60 to 80 years, 35 men and 15 women. They were divided into groups classified according to the stage of the disease, according to the Rating Scale Unified Parkinson's Disease (UPDRS), and the on-off phase of the medication "levodopa" for DP: Group early-intermediate DP and Group stage intermediate-advanced PD; Group on stage, off stage Group. The pictures analyzed in order anterior, posterior, right lateral and left lateral. Statistical analysis: normality test Kolmogorov-Smirnov (KS), the Gaussian distribution. Used non-parametric statistics between groups, the Mann-Whitney test and descriptive statistics, median and interquartile range with significance level of 5%. View previous deviations were in the initial stage the intermediate without statistical significance. In the intermediate stage to the advanced, there was a significant deviation in the variables of acromions Horizontal Alignment, Horizontal Alignment of the anterior superior iliac spines and the angle between the acromial Two and Two anterior superior iliac spines. Rear view, changes found not demonstrated significant deviation in both stages of PD. Side view of right and left lateral relations were statistically significant for all variables. Median values and interquartile range of the phase groups on and off stage for the views anterior, posterior, right side and left side, showed no significant deviation in both phases of symptoms. The center of gravity shifted to the right with adduction, stages "on" and "off". The correlation between the center of gravity in the frontal and sagittal plane with the dominant hand and the side of symptom onset showed no statistical significance. Discussion: The DP provides pronounced postural change: increased cervical lordosis, kyphosis dorsal; anterioriza head; decreases lumbar curvature, and increases the valgus angle of knee flexion; decreases the support base, step zero, reduces postural stability , flexibility; anteriori the center of gravity, changes the base of support. Conclusion: manifestations and postural sway in PA were present in all profiles photographed.
Introdução: A Doença de Parkinson (DP), de cunho degenerativo, origem idiopática, apresenta: tremor de repouso, rigidez muscular, fraqueza dos movimentos espontâneos, alterações da marcha, postura flexora, diminuição do equilíbrio, alterações e instabilidades posturais, deficiência do alinhamento corporal e alterações do controle postural. Para a avaliação postural podemos fazer uso da fotogrametria através do Software para Avaliação Postural (SAPO). Consiste no registro de fotografias do corpo inteiro, em diferentes planos e posturas fornecendo análise da posição das referências anatômicas dos segmentos corporais. O presente estudo utilizou o SAPO, entendendo ser mais uma ferramenta para o cotidiano na área de análise postural aliando, assim, os ambientes cientifico e clínico. Objetivos: avaliar o alinhamento da postura e o controle postural em pacientes com Doença de Parkinson, com idade entre 60 e 80 anos; identificar e quantificar o posicionamento dos segmentos corporais na postura ereta em vista anterior, posterior, lateral direita e lateral esquerda. Material e Método: participaram deste estudo, 50 indivíduos com DP, com idade entre 60 a 80 anos, sendo 35 homens e 15 mulheres. Foram divididos em grupos classificados de acordo com o estágio da doença, segundo a Escala de Avaliação Unificada da Doença de Parkinson (UPDRS), e com a fase on-off da medicação levedopa para a DP: Grupo estágio inicial-intermediário da DP; Grupo estágio intermediário-avançado da DP; Grupo fase on; Grupo fase off. As fotos analisadas na vista anterior, posterior, lateral direita e lateral esquerda. Análise Estatística dos Dados: teste de normalidade Kolmogorov-Smirnov (K-S), no modelo Gaussiano de distribuição. Utilizada a estatística não-paramétrica entre os grupos, pelo teste de Mann-Whitney e a estatística descritiva, com mediana e intervalo interquartil com significância estatística de 5%. Vista anterior, houve desvios na fase inicial à intermediária sem significância estatística. Na fase intermediária à avançada, houve um desvio padrão significativo nas variáveis Alinhamento Horizontal dos Acrômios, Alinhamento Horizontal das Espinhas Ilíacas Ântero-Superiores e no Ângulo entre os Dois Acrômios e as Duas Espinhas Ilíacas Ântero-Superiores. Vista posterior, as alterações encontradas não demonstraram desvio padrão significativos em ambas as fases da DP. Vista lateral direita e lateral esquerda houve relações estatisticamente significantes em todas as variáveis. Valores de mediana e intervalo interquartil dos grupos Fase on e Fase off para as vistas anterior, posterior, lateral direita e lateral esquerda, não demonstraram desvio padrão significativos em ambas as fases dos sintomas. O Centro de Gravidade deslocou-se para a direita com adução, nas fases on e off . A correlação entre o centro de gravidade nos plano frontal e sagital com o lado dominante e com o lado do início dos sintomas não demonstrou significância estatistica. Discussão: A DP propicia acentuada alteração postural: aumenta a lordose cervical, a cifose dorsal; anterioriza a cabeça; diminui a curvatura lombar; aumenta o valgismo e o ângulo de flexão de joelhos; diminui a base de suporte; passo zero; reduz a estabilidade postural, a flexibilidade; anteriori o centro de gravidade; altera a base de sustentação. Conclusão: as manifestações posturais e a oscilação postural, na DP, estiveram presentes em todos os perfis fotografados.

Projeto de Graduação apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Licenciada em Fisioterapia
Objetivo: Analisar quais as principais alterações posturais observadas no voleibolista da 1ª divisão nacional, antes e após um plano de exercícios para o ombro. Métodos: Estudo experimental longitudinal com 39 participantes (22,8±5,5 anos de idade), distribuídos por dois grupos: GC e GE.O GE realizou um plano de exercícios para o ombro durante 6 semanas. A postura foi avaliada por meio de análise computorizada de fotografias baseada no protocolo de avaliação SAPO versão 0.68. Resultados: Inicialmente da comparação intergrupo, conclui-se que apenas a variável AHC7 apresentava diferenças estatisticamente significativas. Após as 6 semanas, verificou-se que apenas existiam diferenças estatisticamente significativas na variável AQD. Na comparação intragrupo, após as 6 semanas, verificou-se que no GC 5 variáveis (ACEIAS, AQD, AQE, AVC E AHP) e no GE 6 variáveis (AFMID, AQE, AVT, AVC, AHP) demonstraram diferenças estatisticamente significativas. Conclusão: O plano de exercícios para o ombro não demonstrou ser eficaz para uma melhoria da postura dos voleibolistas.
Objective: Analyze the main postural changes observed in volleyball players of the 1st national division, before and after an exercise plan to the shoulder. Methods: It’s a longitudinal experimental study with 39 participants (22,8±5,5 years old), assigned to two groups: GC and GE. The GE performed an exercise plan for the shoulder for 6 weeks. The posture was evaluated through computer analysis of photographs based on the evaluation protocol SAPO version 0.68. Results: Initially, with the intergroup comparison, it’s concluded that only AHC7 variable showed significant differences. After 6 weeks, it was found that there were only statistically significant differences in AQD variable. The intragroup comparison, after 6 weeks, it was found that the GC 5 variables (ACEIAS, DQA, AQE, stroke and AHP) and the GE 6 variables (AFMID, AQE, AVT, stroke, AHP) showed statistical differences significant. Conclusion: The exercise plan for the shoulder hasn’t been shown to be effective for improving the volleyball athlete posture.

Maintenance of appropriate posture is essential for the prevention of various musculoskeletal disorders. Postural stress is a common issue in elementary school children. The literature review indicated that schoolteachers have inadequate and improper postural knowledge. Based on such concepts, elementary schoolteachers in this present study implemented a postural awareness education program designed by the American Posture Institute. The present study indicated that postural awareness amongst schoolteachers was significantly low before the start of the program and was significantly increased after implementing the program (p < 0.01). Moreover, the program results seemed to match the expectations of the posture awareness program. However, the analysis also indicated that teachers failed to achieve requisite postural knowledge on all postural concepts (p < 0.01). Hence, the study necessitated the need for improving the postural awareness program (which was designed and developed by API). The study participants failed to develop a holistic knowledge on postural concepts and could not correlate different postural concepts with one another (p > 0.05). The study necessitated the need for sensitizing schoolteachers on different aspects of physiology and anatomy before implementing a postural education program.

The principal aim of this project is to examine posture and muscle activity when using an ergonomically designed saddle seat compared with a conventional seat during common dental procedures with the dental students and practising dentists. The study was conducted with practising dentists across the West Midlands and the dental students in the School of Dentistry – University of Birmingham. The study is mainly divided into a questionnaire survey of practising dentists, a questionnaire survey of dental student posture in the dental schools across the U.K, postural analysis, and a daily symptom survey of practising dentists and dental students, and finally the EMG analysis of practising dentists and dental students working posture. This thesis has established the relationship between posture, seating and muscle activity and indicates that use of an ergonomic aid (dental operator stool) may improve posture, decrease pain and muscle activity and may decrease the development of musculoskeletal disorders among dental students and dentists.

With changes in business practice and life style, increasingly people travel spending prolonged periods of time sitting on airplanes, trains, or cars. Hence sitting comfort has become a critical issue due to fitness and health implications. Focusing on airplanes and based on the idea that a ’responsive environment’ (environment that adapts to independently assessed passengers conditions and adjust itself to them) will provide high level of comfort, we investigated ways of performing a continuos real time physiological monitoring of the passengers. A smart seat is hence the interface structure to allow passengers to be monitored, together with external sensors, such as environmental temperature sensors, humidity sensors, etc. (those last ones are not subjects of the present work). The smart seat is the physiological monitoring system that analyses in real time individual passengers’ status, such as their body temperature, heart rate, posture, activity, etc. Seated posture recognition is the subject of this study. The aim of this study is to evaluate the relevant postures assumed on airplanes’ seats and to develop a robust method for their recognition. Moreover we wanted to develop a commercial prototype of a non-invasive passengers monitoring system on airplanes (i.e. a smart seat capable to detect different aspects of the passenger’s conditions like its body temperature, its activity, etc.). Few studies have been conducted in the past concerning seated posture recognition; all of them involved a high number of sensors for an accurate result. The novelty of this study is the overall simplicity of the system and the commercial feasibility; it is indeed based on the following requirements: the number of sensors involved must be as small as possible so to not interfere with other physiological monitoring modules integrated on the seat (such as temperature evaluation, hearth rate analysis, etc.), and to keep the weight and the cost relatively low. 4 5 The recognition was performed by using a combination of the following devices, depending on the analysis performed: pressure mats mounted on the seat, force plates, and eventually cameras for image analysis. After determining the postures to be classified we created a ’Posture Database’ containing information about the relevant parameters for each of those. Two different approaches to posture recognition were investigated: an analytical method which reconstructs the passenger’s posture by using a small number of inputs (solely form force plates data); and a pattern recognition method that makes guesses about the passenger posture by accessing to the database of classified postures. Both the approaches showed successful results. In this pioneering study we created a Posture Database, not found in literature, and developed methods for seated posture recognition that rely on the use of a limited number of sensor. Furtherly, a prototype of a smart seat capable to recognise the user’s posture was developed within the FP6 project “SEAT: Smart tEchnologies for stress free Air Travel” and it can lead to many exciting applications such as responsive environment and personal comfort settings in vehicles, automatic control of airbag deployment forces, ergonomics of furniture design, and biometric authentication for computer security.

Objetivos: analisar a postura corporal em pacientes disfônicos e correlacioná-los com indivíduos sem alteração de voz, a fim de estabelecer novos recursos terapêutico para reabilitar o portador de disfonia. Método: estudo prospectivo. Foram avaliados 43 indivíduos (23 disfônicos e 20 sem alteração de voz) do sexo feminino,com idade entre 18 e 40 anos ,sem alterações neurológicas ,respiratórias e reumáticas. Todos os pacientes foram encaminhado pelo serviço de Otorrinolaringologia da Escola Paulista de Medicina ( UNIFESP- EPM),após anamnese, exame do otorrinolaringologista e laringoscopia ,tendo como diagnostico de disfonia funcional ou organofuncional. Nessa população foi avaliado: 1- Postura corporal in loco, 2 – Documentação fotográfica, 3 – Exame Eletromiografia, 4 – Questionário das algias. Resultados: não houve diferença estatisticamente significante em relação à queixa,porem foi encontrado um numero maior de tensão muscular e dor na região cervical, onde se encontra situado a laringe, nos portadores de disfonia. Na avaliação postural, os indivíduos disfônicos apresentarão assimetria de ombros, alteração no posicionamento da escapula, retificação com anteriorização da região cervical em relação ao grupo controle. Nos resultados da eletromiografia houve aumento das atividades nos músculos supra-hióideo em emissão prolongada, controlada e deglutição. Nos músculos infra-hióideo houve alteração no traçado eletromiógrafico na emissão prolongada. Conclusão: pode- se concluir que o estudo mostra a existência da correlação positiva entre indivíduos portadores de disfonia e alteração na postura, baseado nas diferenças dos achados clínicos e medidas eletromiográficas.
Objectives: This study analyzed the body posture of dysphonic patients and correlated them with individuals without voice alterations, in order to establish new therapeutic resources to rehabilitate the patients with dysphonia. Method: prospective study. A total of 43 individuals were analyzed (23 with dysphonia and 20 without voice alterations), of female gender, aged 18 to 40 years, without neurological, respiratory and rheumatic alterations. All patients were referred by the ENT Sector of Paulista Medical School (UNIFESP- EPM) after anamnesis, ENT examination and laryngoscopy, with diagnosis of functional or organofunctional dysphonia. The following parameters were investigated in this population: 1- Body posture in loco, 2- Photographic records, 3- Electromyographic examination, 4- Questionnaire on pain. Results: The results indicated no statistically significant difference with regard to the complaint, yet a larger number of individuals with dysphonia reported muscle tension and pain at the cervical region, where the larynx is located. Posture evaluation revealed that dysphonic individuals presented shoulder asymmetry, alterations in scapular positioning and rectification with forward displacement of the cervical region compared to the control group. The results of electromyographic analysis demonstrated increased activity of the suprahyoid muscle in prolonged emission, controlled emission and swallowing. The infrahyoid muscles exhibited altered electromyographic tracing during prolonged emission. Conclusion: It was concluded that there is correlation between individuals with dysphonia and posture alterations, based on the differences in clinical findings and electromyographic measurements.

Orientador: Maria Regina Cavalcante
Banca: Luis Carlos Paschoarelli
Banca: Jair Lopes Junior
Resumo: A postura sentada promovo diversas alterações nas estruturas músculo-esquelética, na circulação dos membros inferiores e no conforto dos membros superiores. Tais alterações produzem consequencias no processo de ensino-aprendizagem no âmbito escolar. Esta pesquisa buscou investigar os efeitos do procedimento de Reforço de Verbalização (RV) e Treino de Correspondência (TC) sobre a postura sentada em escolares e sobre seus relatos acerca dos posicionamentos dos pés, coluna lombar, coluna cervical e antebraços em três sequencias (Dizer-Fazer, Fazer-Dizer e Dizer-Fazer-Dizer). Participaram do estudo 9 alunos do 4º ano do ensino fundamental de uma escola pública do estado de São Paulo, com alturas semelhantes, que foram divididos em três grupos: Dizer-Fazer, (DF), Fazer-Dizer, (FD) e Dizer-Fazer-Dizer (DFD) com três alunos em cada grupo. O procedimento experimental compreendeu 4 condições experimentais: Linha de Base 1, Reforço de Verbalização (as respostas verbais corretas emitidas pelos participantes eram consequenciadas positivamente pela pesquisadora), Treino de Correspondência (a emissão das respostas verbais e dos posicionamentos corretos dos participantes eram consequenciados positivamente) e Linha de Base 2. Para verificar a correspondência entre o comportamento verbal e o não-verbal foi analisada a frequencia das respostas verbais corretas apresentadas pelos alunos em relação aos registros dos posicionamentos apresentados em relação a cada segmento corporal selecionado. Durante a Fase RV a frequencia da verbalização correta aumentou para todos os participantes dos três grupos, e os posicionamentos dos segmentos corporais pés e coluna lombar aumentaram para os participantes dos grupos DF e FD.
Abstract: The sitting posture promotes several changes in the musculoskeletal structures, the movement of the lower limbs and in the comfort of the upper limbs. These effects have consequences in the teaching and learning in schools. This research investigates the effects of the procedure Boost Verbosity (VR) training and correspondence (TC) on sitting posture in children and about his statement regarding the positions of the feet, spine, cervical spine and forearm in three sequences (say-Do, Do-say and Do-Say-Say). Study participants were nine students in the 4th grade of elementary education at a public school in the state of Sao Paulo, with similar heights, which were divided into three groups: Say-Do, (DF), Do-Tell (FD) and Say-Do-Telling (DFD) with three students in each group. The experimental prodedure consisted of four experimental conditions: baseline 1, Strengthening of verbalization (the correct verbal responses issued by the participants were positive consequences for the researcher), Correspondence Training (the emission of verbal responses and the correct positioning of the participants were positive consequences) and Baseline 2. To verify the correspondence between the verbal and nonverbal analyzed the frequency of correct verbal responses made by students in relation to records of the positions presented in relation to each body segment selected. During Phase RV verbalization correct frequency increased for all three groups of participants, and positions of body segments, Iegs and lumbar spine increased for participants in the FD groups. In Phase CT correct verbalization was maintained by all participants of all groups and increased the correct position all body segments and hence the correspondence between the verbal and nonverbal behavior. In LB2 correct verbalization was maintained in all groups and there was a small decrease in matching segments of the cervical spine for all groups and for groups of forearms and DF DFD.
Mestre

Tradicionalmente, a utilização de questionários como instrumento avaliativo da postura corporal nas Atividades de Vida Diária (AVD’s) tem sido amplamente divulgada, seja em estudos descritivos, transversais e longitudinais, ou experimentais, como os programas educativos e as Escolas Posturais. Não obstante, o questionário é baseado em auto-relato, sendo dependente da percepção e do nível cognitivo do avaliado, o que pode resultar em um viés nos resultados, principalmente se os avaliados forem crianças e adolescentes. Deste modo, são necessárias metodologias válidas e reprodutíveis capazes de avaliar a postura corporal dinâmica a partir de observações e filmagens, minimizando o viés resultante do auto-relato. Procurando identificar os instrumentos de avaliação da postura dinâmica já publicados na literatura foi realizada uma busca sistemática de artigos em bases de dados (Scopus, ScienceDirect, PubMed, Scielo) publicados a partir da década de 1980 e no Banco de Teses e Dissertações da Capes. Os instrumentos propostos deveriam preencher os seguintes critérios: (a) avaliar a postura corporal durante a realização de AVD’s; (b) utilizar critérios pré-definidos de avaliação; e (c) avaliar a postura a partir de observação ou a partir de filmagem. Foram identificados oito artigos originais que apresentam instrumentos de avaliação da postura dinâmica, avaliando a execução de AVD’s por meio de critérios biomecânicos pré-definidos, por meio de escalas numéricas, sendo que, destes, apenas quatro foram elaborados especificamente com o propósito de avaliar a execução de AVD’s de escolares. Em geral, considera-se que esses instrumentos apresentem algumas limitações metodológicas, tais como carecerem de procedimentos de validação e de reprodutibilidade. O CAPD, desenvolvido a partir de uma pesquisa de campo e em publicações científicas, possibilita avaliar a postura corporal de nove AVD’s: carregar sacolas e mochila escolar; escrever; pegar objeto do solo e transportá-lo; utilizar o computador portátil e de mesa; sentar em um banco; e ao dormir. Os procedimentos de validade e reprodutibilidade do CAPD consistiram na sua: (a) submissão a sete especialistas, para avaliação científica do conteúdo; (b) determinação da reprodutibilidade inter e intra-avaliador e teste-reteste, a partir da filmagem de 112 escolares; (c) validação de constructo, determinada a partir da comparação dos resultados entre 10 universitários e os escolares. A análise estatística foi realizada no Software SPSS18.0, por meio do Coeficiente de Correlação Intra-Classe (ICC), do Coeficiente Kappa e do teste U de Mann Whitney (α=0,05). Os resultados de cada postura, separadamente, demonstraram que a reprodutibilidade intraavaliador foi classificada como excelente (ICC>0,75) e que a reprodutibilidade inter-avaliador e testereteste foram classificadas como moderada (ICC de 0,4 a 0,75) e excelente (ICC>0,75). Os resultados do Coeficiente Kappa, na avaliação dos critérios de pontuação, demonstraram que (1) a reprodutibilidade intra-avaliador apresentou resultados superiores em comparação à reprodutibilidade inter-avaliador e teste-reteste, e que (2) as posturas ao carregar sacolas, transportar mochila escolar, pegar objeto do solo e transportá-lo e ao dormir apresentaram resultados superiores em comparação às posturas sentadas. Os resultados do teste U de Mann Whitney demonstraram que os acadêmicos apresentaram pontuações significativamente superiores aos escolares para todas as posturas, exceto na postura ao transportar mochila escolar. A partir desses achados, conclui-se que o CAPD é um instrumento válido e reprodutível que pode ser utilizado na avaliação da postura nas AVD’s de escolares.
Traditionally, the use of questionnaires as an evaluation tool of corporal posture in Activities of Daily Living (ADL’s) has been widely spread in descriptive, transversal and longitudinal, or experimental studies as well as educational programs and Back Schools. Notwithstanding, these questionnaires are based on people’s account of their activities thus depending on these people’s perception and cognitive level which may alter the results, especially if the public being evaluated is mainly of children and teenagers. In this way, it is necessary to have valid methodologies that are capable of reproducing and evaluating the corporal dynamic posture from observations and footage, minimizing the altered results that may come out in people’s self-account of facts. In order to identify the evaluation tools of dynamic posture already published, it was carried out a systemic search of papers on the matter on database sites such as Scopus, ScienceDirect, PubMed and Scielo, published from 1980 on, and also on the database of thesis and dissertation of Capes. The tools suggested should meet the following criteria: (a) evaluate the corporal posture during ADL’s; (b) use pre-defined evaluation criteria of dynamic posture; and (c) evaluate posture from direct observation or through footage. Eight original papers that present tools for the analysis of dynamic posture were identified. These papers analysis the ADL’s through pre-defined biochemical criteria, through numerical scale; however, only four tools were elaborated aiming at assessing school students’ ADL’s. In general, it is considered that the tools used present some methodological limitations such as validation and reproducibility procedures. In this sense, aiming at contributing to fill in this gap, the present study has as its objectives to suggest the use of Analysis of Dynamic Posture Apparatus (ADPA) as an assessment tool of corporal posture adopted in DLA’s common among school students in order to determine its validity and reproducibility. ADPA, developed during field researches and scientific publications, allows the evaluation of nine ADL’s corporal postural during activities such as carrying bags and school bags, writing, picking up object from the floor and carrying it, using a computer both laptop and desktop, sitting on a bench, and sleeping. The procedures of validity and reproducibility of ADPA consist in its: (a) submission to seven specialists for content validity; (b) determination of reproducibility inter and intra-evaluator and test-retest through footage of 112 school students; (c) construct validity, determined from the comparison of results among 10 university students and school students. The statistical analysis was carried out on Software SPSS 18.0, through the Intraclass Correlation Coefficient (ICC), Kappa Coefficient and the U de Mann Whitney test (α=0,05). The results of each posture, separately, show that the reproducibility intra-evaluator was classified as excellent (ICC>0,75) and that the reproducibility inter-evaluator and test-retest were classified as moderate (ICC from 0,4 to 0,75) and excellent (ICC>0,75). The results of Kappa Coefficient, in the evaluation of scoring criteria, show that (1) the reproducibility of intra-evaluator showed results that are superior in comparison to the reproducibility inter-evaluator and test-retest; and (2) the posture when carrying bags, school bags, picking up objects from the floor and carrying them and sleeping show results superior in comparison to sitting postures. The results of U de Mann Whitney test show that university students have significantly superior scores to all of the postures, except the one of carrying a school bag. Taking these findings into consideration, it is possible to conclude that APDA has validity and reproducibility and that it is possible to be used in the assessment of posture in school students’ ADL’s.

Thesis (S.B.)--Massachusetts Institute of Technology, Dept. of Mechanical Engineering, 2005.
Includes bibliographical references (p. 53-54).
A method and system has been developed to solve the kinematic redundancy for a humanoid redundant manipulator based on forward kinematic equation and the optimization of human-like constraints. The Multiple Objective Optimization (MOO) is preformed using a Genetic Algorithms (GA) and implemented using the Genetic and Evolutionary Algorithm Matlab Toolbox. The designed system is illustrated on a simple redundant 3 degree of freedom (dof) manipulator and is set up for a more complicated redundant 7 dof manipulator. The 7 dof manipulator is modeled from the Stan Winston studio's Leonardo, an 61 dof expressive humanoid robot. It has been found that the inverse kinematic solution to a 3dof model arm converged within 1% error of the solution within .05 mins processor time using the discomfort human-like constraint in 2d space. Similarly, the inverse kinematic solution to a 7 dof model arm consisting of Leonardo's right arm geometry was found to converge within 1% error within .20 mins processor time using the discomfort human-like constraint in 3D space. The full kinematic model of Leonardo is developed and future efficiency optimizations are posed to move towards the real-time motion control of a redundant humanoid robot by way of human-like posture prediction.
by Derik Thomann.
S.B.

Projeto de Graduação apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Licenciado em Fisioterapia
A adoção de uma má postura pode depender de diversos fatores intrínsecos e/ou extrínsecos, tais como fatores patológicos ou psicossociais, estilo de vida, envelhecimento, e desequilíbrio da harmonia corporal, podendo originar futuras patologias. Objetivo: avaliar o efeito do método Reeducação Postural Global (RPG) na alteração de desvios posturais não patológicos. Metodologia: Vinte indivíduos dos 20 aos 35 anos, com características biológicas e de atividade física similares, foram divididos em dois grupos de dez, um grupo de controlo e outro experimental. No grupo experimental foi aplicado um protocolo de alongamento segundo a RPG (duas posturas), durante 4 semanas, duas vezes por semana, com duração de trinta minutos cada sessão. Ambos os grupos foram submetidos a duas avaliações posturais por biofotogrametria, através do protocolo Sapo v. 0.68, uma no ínicio do estudo e outra no final. Resultados: no final do período observacional, o grupo experimental obteve melhorias estatisticamente significativas em oito das vinte e uma medidas de alinhamento e simetria corporal, enquanto que no grupo de controlo não foram encontradas qualquer alterações significativas. Conclusão: o método RPG é capaz de devolver simetria corporal, corrigindo determinados desalinhamentos posturais.
The adoption of a bad posture can depend on several intrinsic and / or extrinsic factors, such as disease or psychosocial factors, lifestyle, aging, and imbalance of body harmony, may lead to future conditions. Objective: To evaluate the effect of global postural reeducation (GPR) method on non-pathological postural deviations. Methods: Twenty subjects between 20 and 35 years, biological and similar physical activity characteristics were divided into two groups of ten, a control group and an experimental. In the experimental group was assigned a stretching protocol according to RPG (two positions) for 4 weeks, twice a week, lasting thirty minutes each session. Both groups underwent two evaluations by postural photogrammetry, by Sapo v 0.68 protocol, one at the beginning of the study and one at the end. Results: At the end of the observation period, the experimental group had a statistically significant improvement in eight of the twenty-one alignment measures and body symmetry, while in the control group were not found any significant changes. Conclusion: RPG method is capable of restoring body symmetry, correcting certain postural misalignments.

The purpose of this master's thesis is to study the enigmatic figure of Wajdi Mouawad, looking into the dramatic quartet Le Sang des promesses, the interviews the author gave over time, as well as his physic appearance and his public acts. We look to, with the help of the Meizoz's theory, better understand the "posture" of the writer, claimed as here as in France. The first chapter treats, with the metaphoric figure of the looter, the dramatist's propensity to take over other people's words, their speech and even the story of a people for the benefit of his own work. The second chapter shows interest for searches Mouawad makes, as an archeologist, in his past and to the origin of literature, all this building traces he would like to let to posterity. The third chapter addresses the dramatic author's ambivalence, which like the image of the God Janus, seems to have many contradictory faces. As we learned through this study, it is impossible to crack the mystery surrounding the enigmatic "posture" of the Libanese-Quebecer writer. However, it is obvious that Mouawad stages his own life the same way he stages his plays.
Le but de ce mémoire est de se pencher sur la figure énigmatique de Wajdi Mouawad, et ce, en étudiant le quatuor dramatique Le Sang des promesses, les entretiens qu'il a accordés au fil du temps, ainsi que son apparence physique et ses agissements en public. Nous tentons, à l'aide de la théorie de Meizoz, de mieux comprendre la posture de cet écrivain acclamé ici, comme en France. Le premier chapitre aborde, à l'aide de la figure métaphorique du pilleur, la propension du dramaturge à s'approprier les mots des autres, leur parole et même l'histoire d'un peuple pour le bénéfice de sa propre entreprise. Le deuxième chapitre s'intéresse aux fouilles que Mouawad fait, tel un archéologue, dans son passé et à l'origine de la littérature, et ce, tout en fabriquant des traces qu'il aimerait laisser à la postérité. Le troisième chapitre s'attaque à l'ambivalence de l'auteur dramatique qui, à l'image du dieu Janus, semble avoir plusieurs visages contradictoires. Au terme de cette étude, nous comprenons qu'il est impossible de percer le mystère de la posture énigmatique de l'écrivain libano-québécois. Toutefois, il est clair que Mouawad se met en scène, qu'il écrit son histoire à la manière de ses pièces.

The ability to stand still in one place is important in a variety of activities of daily living. For persons with motion disorders, orthopaedic treatment, which changes geometric or biomechanical properties, can improve the individual'sposture and walking ability. Decisions on such treatment require insight in how posture and walking ability are aected, however, despite expectations based on experience, it is never a-priori known how a patient will react to a treatment. As this is very challenging to observe by the naked eye, engineering tools are increasingly employed to support clinical diagnostics and treatment planning. The development of predictive simulations allows for the evaluation of the eect of changed biomechanical parameters on the human biological system behavior and could become a valuable tool in future clinical decision making. In the first paper, we evaluated the use of the Zero Moment Point as a computationally inexpensive tool to obtain the ground reaction forces (GRFs) for normal human gait. The method was applied on ten healthy subjects walking in a motion analysis laboratory and predicted GRFs are evaluated against the simultaneously measured force plate data. Apart from the antero-posterior forces, GRFs are well-predicted and errors fall within the error ranges from other published methods. The computationally inexpensive method evaluated in this study can reasonably well predict the GRFs for normal human gait without using prior knowledge of common gait kinetics. The second manuscript addresses the complications in the creation and analysis of a posture prediction framework. The fmincon optimization function in MATLAB was used in conjunction with a musculoskeletal model in OpenSim. One clear local minimum was found in the form of a symmetric standing posture but perturbation analyses revealed the presence of many other postural congurations, each representing its own unique local minimum in the feasible parameter space. For human postural stance, this can translate to there being many different ways of standing without actually noticing a difference in the efforts required for these poses.

This work was financially supported by the Swedish Scientic Council(Vetenskapsrådet) grant no. 2010-9401-79187-68, the ProMobilia handicapfoundation (ref. 13093), Sunnerdahls Handicap foundation (ansökan nr 11/14),and Norrbacka-Eugenia foundation (ansökan nr 218/15).

During this thesis, we have proposed a real-time, generic, and operational approach to recognising human posture with one static camera. The approach is fully automatic and independent from the view point of the camera. Human posture recognition from a video sequence is a difficult task. This task is part of the more general problem of video sequence interpretation. The proposed approach takes as input information provided by vision algorithms such as the silhouette of the observed person (a binary image representing the person and the background), or her/his position in the scene. The first contribution is the modeling of a 3D posture avatar. This avatar is composed of a human model (defining the relations between the different body parts), a set of parameters (defining the position of the body parts) and a set of body primitives (defining the visual aspect of the body parts). The second contribution is the proposed hybrid approach to recognise human posture. This approach combines the use of 3D posture avatar and 2D techniques. The 3D avatars are used in the recognition process to acquire a certain independence from the camera view point. The 2D techniques represent the silhouettes of the observed person to provide a real-time processing. The proposed approach is composed of two main parts: the posture detection which recognises the posture of the detected person by using information computed on the studied frame, and the posture temporal filtering which filters the posture by using information about the posture of the person on the previous frames A third contribution is the comparison of different 2D silhouette representations. The comparison is made in terms of computation time and dependence on the silhouette quality. Four representations have been chosen: geometric features, Hu moments, skeletonisation, and the horizontal and vertical projections. A fourth contribution is the characterisation of ambiguous postures. Ambiguities can happen by using only one camera. An ambiguous posture is defined as a posture which has visually similar silhouettes rather an other posture. Synthetic data are generated to evaluate the proposed approach for different point of view. The approach has also been evaluated on real data by proposing a ground truth model adapted to the posture recognition purpose. A fifth contribution has been proposed by applying the results of the recognition to human action detection. A method based on a finite state machine has been proposed to recognise self-action (action where only one person acts). Each state v of the machine is composed of one or several postures. This method has been successfully applied to detect falling and walking actions. The human posture recognition approach gives good results. However, the approach has some limitation. The main limitation, is that we are limited in terms of postures of interest for computation time and discrimination reasons. The second limitation is the computation time of the 3D posture avatar generation. By using information about the movement of the observed person in the scene, the approach is able to treat 5-6 frames by second. Some improvement can be done to solve these limitations. In particular, the set of interest postures can be adapted automatically at each frame by considering the previously recognised postures to decrease the number of 3D posture silhouette to extract
Durant cette thèse nous avons proposé une approche temps réel, générique et fonctionnelle pour reconnaître la posture des personnes filmées par une caméra statique. Notre approche est conçue pour être complètement automatique et indépendante du point de vue de la caméra. La reconnaissance de posture à partir de séquence vidéo est un problème difficile. Ce problème s'inscrit dans le champ de recherche plus général de l'interprétation de séquence vidéo. L'approche proposée prend en entrée des informations provenant d'algorithmes de vision telles que la silhouette de la personne observée (une image binaire où une couleur représente la personne et l'autre le fond) ou sa position dans la scène. La première contribution est la modélisation d'un avatar 3D de posture. Un avatar 3D de posture est composé d'un modèle 3D humain (définissant les relations entre les différentes parties du corps), d'un ensemble de paramètre (définissant les positions des différentes parties du corps) et d'un ensemble de primitive (définissant l'aspect visuel des parties du corps). La seconde contribution est la proposition d'une approche hybride combinant l'utilisation de modèles 3D et de techniques 2D. Les avatars 3D de postures sont utilisés dans le processus de reconnaissance pour avoir une certaine indépendance du point de vue de la caméra. Les techniques 2D représentent les silhouettes des personnes détectées pour garder un temps réel de calcul. Cette thèse montre comment les avatars 3D peuvent être utilisés pour obtenir une approche générique et fonctionnelle pour reconnaître les postures. Cette approche est composée de deux parties : la détection de postures qui reconnaît la posture de la personne détectée en utilisant seulement l'information calculée sur l'image considérée, et le filtrage temporel de posture qui reconnaît la posture en utilisant l'information provenant des images précédentes. Une troisième contribution a été faite en comparant différentes représentations 2D des silhouettes au niveau du temps de calcul nécessaire et de leur dépendance à la qualité de la silhouette. Quatre représentations ont été retenues : une représentation combinant différentes valeurs géométriques, les moment de Hu, la skeletonisation et les projections horizontale et verticale. Une quatrième contribution est la caractérisation des cas ambigus. Des ambiguïtés au niveau de la reconnaissance peuvent se produire en utilisant seulement une caméra statique. Une posture ambiguë est définie par plusieurs postures vii qui ont des silhouettes visuellement similaires. Des données de synthèse sont générées pour évaluer l'approche proposée pour différents points de vue. Ainsi, les postures ambiguës sont identifiées en considérant la posture et son orientation. L'approche est aussi évaluée pour des données réelles en proposant un modèle de vérité terrain pour la reconnaissance de posture. Une cinquième contribution a été proposée en appliquant le résultat de notre approche à la reconnaissance d'action. Une méthode utilisant des machines à états finis a ainsi été proposée pour reconnaître des actions faisant intervenir une seule personne. Chaque état de la machine est composé d'une ou plusieurs postures. Cette méthode est appliquée avec succès pour détecter les chutes et la marche. Bien que notre approche donne de très bon taux de reconnaissance, il subsiste quelques limitations. La principale limitation de l'approche est qu'elle est limitée en nombre de postures d'intérêt pour des raisons de temps de calcul et de discrimination entre les postures considérées. La seconde limitation est le temps nécessaire à la génération des silhouettes des avatars 3D de posture. En utilisant l'information sur le déplacement de la personne dans la scène, l'algorithme de reconnaissance de posture traite entre 5 et 6 images par seconde. Des améliorations peuvent être faites pour résoudre ces limitations. En particulier, nous pourrions adapter automatiquement l'ensemble des postures d'intérêt au cas considéré, en utilisant par exemple la posture reconnue précédemment pour restreindre les postures 3D dont nous voulons extraire les silhouettes

What is the ideal human upright posture? Where did it come from, how did it develop, what is its significance, how is it measured? What are the cause and effect of malposture? Much has been published on the role of posture in physical as well as mental and emotional states of the individual. This study was undertaken to investigate these issues, while at the same time aiming to find the position and role of posture in the physical and psychological context of human life. The first aspect of posture investigated was its definition. What constitutes good posture is still a debated issue. The conclusion drawn was that good posture represents the state of balance in an individual at rest and during motion. Ideally this state should be achieved with all the body parts aligned on top of each other requiring minimal effort and energy expenditure. The evolutionary origin of the upright posture in man was traced in order to come to a clearer understanding of the anatomical, biomechanical and physiological mechanisms involved in posture. The positions and functions of some muscles and bones have remained, and some have changed during the development of the upright human from its quadrupedal ancestors. Maintenance of balanced posture depends mainly on the coordinated action of the stabilizing mono-articulated muscles, and their place and purpose in upright man were viewed in the light of their origins. By so doing one is able to uncover their intended use and to identify misuse of these muscles. Development throughout childhood mimics the evolutionary process. A series of postural exercises was described, which follows the childhood/evolutionary pattern, and have proven to be successful in postural rehabilitation and body¬mind integration. In order to understand the concept of the upright standing posture, control mechanisms responsible for maintaining upright posture were reviewed. These included the sensory and the neuromusculo-skeletal systems. This was duly undertaken in accordance with existing literature, it was concluded that posture is controlled in association with all human functions. Following the concept that posture affects the mind and emotions, the work and theories of prominent researchers in the body-mind and postural integration field such as Frederick Alexander, Raymond Dart, Moshe Feldenkrais, Alexander Lowen, Wilhelm Reich and Ida Rolf were reviewed and distilled. This led to evidence that treatment of the body has an effect on the mind, that structure influences function and that postural equilibrium has a beneficial influence on both mind and body. According to numerous workers malposture in man is pandemic. Ensuing literature and empirical research on total body posture, and the position of each area of the body, from the head to the feet, revealed divergent causes of this problem as well as effects of malposture, including negative self-image, psycholological problems, pain, fatigue and the inability to achieve the full human potential. Although there is no obvious cause of postural imbalance, there are many ways of preventing or rectifying the disorder. During the course of a postural rehabilitation therapy, there is a good chance of uncovering the underlying cause of the postural imbalance. This can be as deep seated as a personality disorder or as clear as the fear of an old sport injury. The incidence and extent of postural defects were investigated in two small groups of subjects with the aim to determine the range of postural deviations, and the body areas most commonly affected. All subjects studied, leaned forward with the gravity line anterior to the ankle joint. Postural defects were prevalent in all subjects. Most of the subjects were categorized as having severe postural defects or gross deformity. Postural asymmetry and kyphosis were the most common defects. The conclusions drawn from these studies were that most people, in any age group, suffer from some type of postural defect, supporting the general consensus that malposture is a pandemic condition. The effects of postural rehabilitation were also investigated. Postures improved in all the subjects over a period of twelve weeks, with a more vertical body alignment the most obvious change. Postural rehabilitation has physical and psychological consequences. This was demonstrated by improvement in posture and increased body awareness, a decrease in the tendency to become fatigued, an decrease in back and neck stiffness and improvement in mental attitudes. Postural training in general could therefore be profitable for both body and mind, and an appreciation of good posture and its resulting efficiency represents the best kind of preventative medicine. Postural training should have a place in both Education and Health.
Thesis (D Phil (HMS))--University of Pretoria, 2007.
Arts, Languages and Human Movement Studies Education
Unrestricted

Orientador: Fausto Berzin
Tse (doutorado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba
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Resumo: O objetivo do presente estudo foi avaliar as características eletromiográficas e estabilográficas de indivíduos com e sem disfunção temporomandibular (DTM), durante as posturas mandibulares de repouso, de contração isométrica durante o apertamento dentário em máxima intercuspidação (ISOM) e de contração isotônica durante atividade mastigatória não-habitual (ISOT). Na avaliação das características eletromiográficas as seguintes variáveis foram consideradas: raiz quadrada da média normalizada (RMSn) e simetria da atividade dos músculos Temporal, Masseter e Esternocleidomastóide. As variáveis estabilográficas avaliadas foram: índice de oscilação postural, máxima distância medial-lateral, máxima distância anterior-posterior e simetria medial-lateral. Participaram deste estudo 40 voluntários do gênero feminino, sendo 20 destes com sinais e sintomas de disfunção temporomandibular e 20 indivíduos assintomáticos, constituindo o grupo controle. As variáveis foram analisadas por meio da Análise de Variância de Medidas Repetidas e em caso de efeitos significativos procederam-se comparações múltiplas, utilizando o teste t. O nível de significância foi p< 0.05. Os resultados deste estudo indicaram que indivíduos com DTM apresentam mais dor na região cervical (p<0.05), mostrando que as alterações do sistema motor mandibular são relacionadas com alterações no sistema cervical. Os indivíduos com DTM também apresentaram maior assimetria na atividade dos músculos temporal (p<0.001), masseter (p<0.0001) e esternocleidomastóide (p<0.0001) e maior assimetria na distribuição de peso medial-lateral (p<0.01) em relação ao grupo controle. No grupo com DTM foi observada uma significativa redução no índice de oscilação (p<0.05) e na máxima distância medial-lateral (p<0.05). A dor cervical neste grupo pode ter influenciado na redução dos movimentos cervicais para estabilizar a cabeça com um aumento da estabilidade postural. O padrão assimétrico de ativação dos músculos elevadores da mandíbula e do pescoço pode ser interpretado como uma estratégia compensatória para encontrar estabilidade para o sistema mandibular e cervical durante a função mastigatória
Abstract: The objective of the present study was to evaluate the electromyographic (EMG) and stabilographic characteristics of individuals with and without temporomandibular disorder (TMD), during the mandibular rest position (MRP), the isometric contraction during maximal intercuspal position (MIP), and the isotonic contraction during no habitual chewing cycle (CC). In the evaluation of the EMG characteristics the following variable had been considered: normalized root mean square (nRMS) and symmetry of the temporalis, masseter and sternocleidomastoid (SCM) muscles. The evaluated stabilographic variables had been: sway index, maximum medial-lateral distance, maximum anteriorposterior distance and symmetry medial-lateral. This study evaluated 40 female volunteers: 20 with signals and symptoms of TMD and 20 asymptomatic individuals, constituting the control group. The variables were analyzed through repeated measures Anova and in case of significant effect multiple comparisons had been applied, using test t. The level of significance was p< 0.05. The results of this study had indicated that individuals with TMD present more pain in the cervical region (p<0.05), showing that the alterations of the mandibular motor system are related with alterations in the cervical system. The individuals with TMD had also presented greater asymmetry in the activity of the temporalis (p<0.001), masseter (p<0.0001) and SCM (p<0.0001) muscles and greater asymmetry in the medial-lateral distribution of weight (p<0.01) in relation to the control group. In the group with TMD was observed a significant reduction in the sway index (p<0.05) and maximum medial-lateral distance (p<0.05). Cervical pain in TMD group can have influenced in the reduction of the cervical movement to stabilize the head with an increase of the postural stability. The asymmetric activation of jaw and neck muscles is interpreted as a compensatory strategy to achieve stability for mandibular and cervical system during masticatory function
Doutorado
Anatomia
Mestre em Biologia Buco-Dental

Orientador: Jose Dirceu Ribeiro
Dissertação (mestrado) - Universidade Estadual de Campinas. Faculdade de Ciencias Medicas
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Resumo: Objetivo: Verificar a influência do tipo respiratório oral (RO) e nasal (RN) e da classificação da postura corporal em variáveis clínicas, em crianças e adolescentes com a Síndrome do Respirador Oral (SRO) em relação a um grupo controle na mesma faixa etária. Métodos: Estudo observacional, descritivo, de corte transversal, com grupo controle, em Hospital Universitário. Foram incluídas crianças e adolescentes randomizados em 2 grupos: RN e RO. Sendo o grupo de RN composto de indivíduos saudáveis correspondente ao grupo controle. O grupo RO incluiu maiores de cinco anos, de qualquer etnia, masculino e feminino, com diagnóstico de RO confirmado por exame clínico médico e nasofibroscopia, e que assinaram o termo de consentimento livre e esclarecido. Para os voluntários do grupo controle participaram sujeitos saudáveis da mesma faixa etária, que fizeram avaliação médica para confirmar o tipo respiratório. Os participantes de todos os grupos preencheram a ficha de coleta de dados e realizaram a avaliação postural. Resultados: Foram incluídos 306 RO e 124 RN. O tipo RO conferiu maior prevalência no gênero masculino (p=0,0002), maior grau e freqüência de obstrução nasal e tamanho das amígdalas (p=0,0001), presença de rinite alérgica (p=0,0001), padrão respiratório torácico (p=0,0001), palato ogival (p=0,0001) e classificação postural desfavorável (p=0,0001). Os índices de classificação postural foram diretamente proporcionais ao comprometimento nas variáveis clínicas de obstrução nasal (p=0,0001) e gênero masculino (p=0,0008). Conclusões: O tipo respiratório e a classificação postural demonstram influências significativas em alterar variáveis clínicas. Os dados encontrados reforçam a necessidade da precocidade no tratamento interdisciplinar de crianças e com RO.
Abstract: Objective: To assess the influence of mouth breathing (MB) and nose (NR) and the classification of body posture on clinical variables in children and adolescents with Mouth Breathing Syndrome (MBS) compared to a control group of similar age. Methods: An observational, descriptive, cross-sectional with control group at University Hospital. We included children and adolescents randomized into 2 groups: NR and MB. As the NR group composed of healthy individuals corresponding to the control group. The MB group included more than five years, any ethnicity, male and female, diagnosed with MB confirmed by clinical examination and medical endoscopy, and signed a consent form. For the volunteers in the control group participated in healthy subjects of similar age, who have medical evaluation to confirm the respiratory type. Participants from all groups completed the summary of data collection and performed the postural assessment. Results: A total of 306 MB and 124 NR. Type MB produced greater prevalence in males (p = 0.0002), higher degree and frequency of nasal obstruction and size of the tonsils (p = 0.0001), presence of allergic rhinitis (p = 0.0001), respiratory pattern thoracic (p = 0.0001), palate (p = 0.0001) and postural unfavorable rating (p = 0.0001). Classification indices posture was directly proportional to the commitment in the clinical variables of nasal obstruction (p = 0.0001) and males (p = 0.0008). Conclusions: The respiratory type and postural classification shows significant influence in changing clinical variables. These results reinforce the need for early in the interdisciplinary treatment of children witer MB.
Mestrado
Saude da Criança e do Adolescente
Mestre em Saude da Criança e do Adolescente

Orientador: Cecilia Guarnieri Batista
Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas
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Resumo: A criança de 10 a 13 anos está em fase de crescimento e desenvolvimento, a literatura destaca que a flexibilidade é maior nessa fase, porém, aponta para uma alta prevalência de alterações posturais na coluna dessa população. A Ginástica Holística se relaciona com a postura e flexibilidade através dos processos metodológicos utilizados em cada aula. Nelas são abordados os seguintes aspectos: relaxamento, respiração, alongamento e equilíbrio. Objetivo: Relacionar a prática de Ginástica Holística com postura e flexibilidade em meninas de 10 a 13 anos. Método: Estudo de caráter experimental com meninas de 10 a 13 anos de escolas públicas dos municípios de Campinas/SP e Hortolândia/SP. A amostra constituiu-se de 43 meninas saudáveis (22 no grupo experimental e 21 no grupo controle). Foi feita a avaliação postural quantitativa através da fotogrametria (software de avaliação postural SAPO) para analisar e mensurar a postura e flexibilidade das meninas. A flexibilidade foi medida também pelo teste da distância do 3º dedo ao solo. Após a avaliação foram realizadas 9 aulas de Ginástica Holística com o grupo experimental. Resultados: Os dados foram analisados estatisticamente, adotando-se o nível de significância 5%. Para comparação das alterações posturais entre grupos foi utilizado o teste de Mann-Whitney e para comparação de medidas numéricas entre os dois grupos ao longo do tempo foi utilizada a ANOVA. Em relação à postura os resultados demonstram que, após a intervenção, as participantes do grupo experimental apresentaram redução significativa na diferença do comprimento dos membros (CMI) e uma aproximação do padrão de verticalidade (AVCE). Constatou-se também um aumento na extensão coxo-femoral para os dois grupos. Em termos de flexibilidade, houve diferenças significativas: as participantes do grupo experimental apresentaram maior flexibilidade nas medidas (MF1), (MF2) e (MF3)
Abstract: The 10 to 13-year old child is in a growth and development stage. Literature emphasizes that flexibility is greater at this stage, although it also indicates a high prevalence of postural alterations in this population's spine. Holistic Gymnastics relates itself to posture and flexibility through methodological processes used in each class, in which aspects such as relaxation, respiration, stretching and balance are approached. Aim: To relate the practice of Holistic Gymnastics to posture and flexibility in 10 to 13- year-old females. Method: A study of experimental character with 10 to 13- year- old females of the towns of Campinas/SP and Hortolândia/SP. The sample constituted of 43 healthy girls (22 in the experimental group and 21 in the control group). The quantitative postural evaluation was carried out through photogrammetry (SAPO postural evaluation software) to analyze and measure the girls' posture and flexibility. Flexibility was also measured through the third-toe-to-the-ground distance test. After the evaluation, 9 Holistic Gymnastics classes were conducted with the experimental group. Results: Data was analyzed statistically, and the 5% significance level was adopted. The Mann-Whitney test was used for comparison of the postural alterations between groups, and ANOVA was used to compare the numeric measures between the 2 groups over time. In relation to posture, the results demonstrate that, after intervention, the participants in the experimental group showed a significant reduction in the difference of lower limb length (CMI) and an approximation of the verticality pattern (AVCE) - vertical body alignment left lateral view. An increase in the coxofemoral extension was also found for the 2 groups. In terms of flexibility, there were significant differences: the experimental group participants showed greater flexibility in the measures (MF1), (MF2) and (MF3)
Mestrado
Interdisciplinaridade e Reabilitação
Mestra em Saúde, Interdisciplinaridade e Reabilitação

O acidente vascular encefálico é umas das afecções mais prevalentes e incidentes no mundo. O objetivo geral desta tese foi avaliar as variáveis biomecânicas e clínicas do controle postural em sujeitos com sequelas crônicas de acidente vascular encefálico isquêmico após o treinamento aeróbio realizado em piscina e esteira ergométrica. Participaram 12 adultos que sofreram um acidente vascular cerebral e eram capazes de andar com independência que foram divididos aleatoriamente nos grupos esteira e piscina. Para avaliação clínica foram usadas as escalas: avaliação postural para pacientes pós-AVC, equilíbrio de Berg, avaliação sensório-motora Fugl-Meyer, Medical Outcomes Study 36, teste de caminhada de seis minutos e Timed up and go. Para a avaliação biomecânica, foram analisadas as séries temporais da atividade eletromiográfica de 10 músculos do membro inferior em duas tarefas: alcance funcional e flexão do ombro não parético a 90o. A frequência de aquisição foi 2 kHz. O acelerômetro foi usado para indicar o início e término de movimento e o footswitch foi usado para indicar o término da tarefa de alcance funcional. O protocolo de treinamento aeróbico foi feito após a avaliação ergométrica determinar a aptidão cardiorrespiratória e da intensidade de exercício individual. Após 29 sessões de treino, os sujeitos realizaram novamente as avaliações clínicas e biomecânica. As variáveis biomecânicas durante o ajuste postural antecipatório, compensatório e online, e do movimento voluntário foram: pico de aceleração e de velocidade, root mean square, sinal eletromiográfico integrado, frequência mediana, sinergia, variabilidade, latência e resíduo. A análise de variância mostrou o aumento dos escores da Fugl-Meyer, Medical Outcomes Study 36, Timed up and go e equilíbrio de Berg pós treinamento. Houveram mudanças no root mean square, sinal eletromiográfico integrado, frequência mediana, sinergia, variabilidade, latência e resíduo após treinamento aeróbio, entre os grupos e os hemicorpos. O treino aeróbio melhorou a agilidade, equilíbrio e qualidade de vida de pessoas com AVC e modificou a sinergia postural de forma diferente entre os grupos piscina e esteira e para os ajustes posturais. A segunda análise foi feita com a regressão linear múltipla para conhecer as relações entre variáveis biomecânicas e clínicas. Houve relação forte entre as variáveis biomecânicas e clínicas na tarefa de alcance funcional
Stroke is one of the most prevalent and incident diseases in the world. In this study, we evaluated the clinical and biomechanical variables of postural control in subjects with chronic of ischemic stroke after exercise training performed in a pool and a treadmill. The participants were 12 adults with stroke that were able to walk without any external device. The clinical evaluation scales were applied: postural assessment for post-stroke patients, Berg balance test, sensorimotor assessment Fugl-Meyer test, the medical outcomes study 36 test, the six-minute walk test and the timed up and go test. For biomechanical evaluation, we analyzed the electromyographic activity of 10 muscles of the lower limb during two tasks: functional reach and shoulder flexion. The sampling frequency was 2 Hz. We attached a accelerometer at the wrist to have the information about the start and end of the movement and we use a footswitch to get the information about the end of the functional reach test. The training protocol was planned after ergometric evaluation for the cardiorespiratory condition and individual exercise load. After 29 training sessions, subjects underwent clinical and biomechanical analyses again. The biomechanical variables from the anticipatory postural adjustment, compensatory and online, and voluntary movement were: peak acceleration and velocity, root mean square, integrated electromyographic signal, median frequency, synergy, variability, and residual latency. Analysis of variance showed increased scores of Fugl-Meyer, The medical outcomes study 36 test, the timed up and go test and the Berg balance scale test after the training. The changes in the root mean square, integrated electromyographic signal, median frequency, synergy, variability, latency and residue after aerobic training, between groups and hemicorpos were observed. The aerobic training caused an improvement in agility, balance and quality of life of people with stroke and modified the basic mechanisms and synergy postural differently between groups, pool and treadmill, and postural adjustments. The second analysis was performed using the multiple linear regression model to understand the relationships between biomechanical and clinical variables. There was a strong relationship between the biomechanical and clinical variables in the task of functional reach

A influência das alterações posturais na produção da voz é um assunto bastante interessante e de grande importância para aqueles que utilizam a voz profissionalmente. O objetivo do presente estudo é identificar a influência no sinal vocal de um mesmo indivíduo quando este muda sua postura corporal. Foram realizadas as análises de 25 amostras vocais de um indivíduo que emitiu a vogal sustentada /a/ em três diferentes posturas corporais: A) ortostática natural do sujeito; B) anteriorização da cabeça associada com extensão da coluna cervical; e C) aumento da cifose torácica associada com anteriorização de cabeça. O indivíduo foi fotografado simultaneamente ao processo de gravação da voz. As posturas foram avaliadas por fotogrametria pelo programa Corel Draw 10. A voz foi analisada por análise acústica por meio do programa MDVP inserido no software Multi Speech 3700 da Kay Elemetric Corporation e pela avaliação perceptivo-auditiva da voz. O resultado comparativo entre as amostras vocais nas posturas A e B foi significante, na análise acústica, na variável e jitter (%); e na avaliação perceptivo-auditiva, as diferenças observadas foram referentes à qualidade vocal, à ressonância e ao pitch, que se tornou mais agudo em 56% das amostras. Na comparação das posturas A e C, não houve resultado significativo na análise acústica; e na avaliação perceptivo-auditiva as mudanças percebidas foram referentes à qualidade vocal, à ressonância e ao pitch, que se tornou mais agudo em 60% das amostras. Conclusão: as diferenças observadas na comparação das posturas A e B foram: aumento do valor médio de jitter; aumento do pitch; ressonância se tornou posterior e abafada; e piora na qualidade vocal. As diferenças observadas na comparação das posturas A e C foram: aumento do pitch; ressonância se tornou comprimida; e piora na qualidade vocal.
The influence of the different corporal postures in the voice production is a very interesting subject and it\'s very important for those who use their voice professionally. The aim of the present investigation is to identify the influence in the voice signal of the same subject whenever he changes his corporal posture. It was made the analysis of 25 vocal samples of one subject who emitted the vocal sustained /a/ in three different corporal postures: A) normal alignment of the subject; B) cervical spine extension associated with forward head position; and C) increased thoracic kyphosis associated with forward head position. The subject was photographed simultaneously of the recording process. The postures were evaluated by photogrammetry by the Corel Draw 10 program. The voice was analyzed by acoustic analysis by the MDVP program inserted in the Multi Speech 3700 software from Kay Elemetric Corporation and by perceptual speech analysis. The comparative result between the voices samples in the postures A and B was significant, to the acoustic analysis, to the variable jitter (%); and to the perceptual speech analysis, the differences observed were related to vocal quality, resonance and pitch, which turned out to be more acute in 56% of the samples. In the comparison of the postures A and C, there wasn\'t significant result in the acoustic analysis; and to the perceptual speech analysis the changes noticed were related to vocal quality, resonance and pitch, which turned out to be more acute in 60% of the samples. Conclusion: the differences observed on the comparison of the postures A and B were: jitter medium value increased; pitch increased; resonance turned out to be posterior and muffled; and worse voice quality. The differences observed on the comparison of the postures A and C were: pitch increased; resonance turned out to be compressed; and worse voice quality.

A Osteoartrite é o resultado da degeneração da cartilagem articular, sendo atualmente considerada uma condição comum e de causa multifatorial que afeta milhões de pessoas anualmente e uma das principais causas de dor e incapacidade funcional. Os joelhos são uma das articulações mais afetadas devido à sobrecarga, que constitui o principal mecanismo ativador ou determinante para o desenvolvimento da doença. Há diminuição importante da amplitude de movimento e da força muscular que acarreta em uma limitação funcional e alterações posturais interferindo nas atividades de vida diária. O objetivo principal desta pesquisa foi caracterizar as alterações posturais e a atividade eletromiográfica em pacientes com osteoartrite de joelho. Este estudo envolveu 30 mulheres voluntárias divididas em dois grupos: Grupo controle (GC) composto por 15 idosas (66,0±4,5 anos, IMC de 25,4±2,29 Kg/m2) e um grupo composto de 15 idosas com diagnóstico radiográfico de OA de joelhos Grupo osteoartrite (GO) (67,0±5,8 anos, IMC de 26,2±2,98 Kg/m2) bilateralmente, sendo um joelho sintomático e um assintomático. Para a análise postural foi utilizado o programa SAPO® na qual foram realizadas fotografias no plano sagital e frontal. Através do programa foram mensurados o ângulo Q e o ângulo do joelho bilateralmente. Foi realizada a avaliação eletromiográfica na CIMV bilateralmente do vasto lateral e medial. A avaliação na CIMV foi realizada com os sujeitos sentados na maca (joelhos em 90º de flexão). Foi solicitado ao sujeito realizar uma extensão de joelho ativa contra a resistência durante cinco segundos, repetindo esse processo por três vezes. Para a análise estatística foram utilizados teste de Shapiro-Wilk para normalidade, teste Levene para homocedasticidade e o teste de correlação de Spearman. As comparações entre os grupos foram realizadas por meio de duas ANOVAs one-way. No GO os sujeitos apresentaram uma capacidade funcional muito grave (IFL = 12), e de gravidade moderada na avaliação radiológica (escala de Kellgren = 2), no GC os sujeitos não possuíam dor. No GO o ângulo Q foi de 19,9º para o joelho com OA e de 19,1º para o assintomático (p=0,732). No GC obteve-se um ângulo Q de 19,8º (p=0,955) entre os dois joelhos. Na distância intercondilar o GC foi de 2,9 cm enquanto que no GO foi de 5,3 cm (p=0,168) e na distância intermaleolar o GC foi de 7,2 cm e no GO foi de 12,3 cm (p=0,156). Houve diferença estatística nos valores nas RMS do vasto lateral e medial nos joelhos controle (VL=545,2±40V / VM=456,9±45V) em relação aos joelhos sintomáticos (VL=338,6±54V / VM=291,7±40V) (p=0,001) para ambos os músculos. Já nas comparações entre os joelhos controle (VL=545,2±40V / VM=456,9±45V) e assintomático (VL=540,9±19V / VM=443,8±18V) não foram observados diferenças estatísticas (p=0,430 para VL e p=0,956 para VM). Nas comparações entre os joelhos sintomáticos (VL=338,6±54V / VM=291,7±40V) e assintomáticos (VL=540,9±19V / VM=443,8±18V) foram observadas as diferenças estatísticas significativas nos dois músculos analisados (p=0,001 para ambos). Ocorreu um predomínio de joelhos valgos nos dois grupos sem significância estatística. Na eletromiografia de superfície as portadoras de osteoartrite de joelhos apresentaram alterações na atividade muscular como diminuição da atividade muscular em VL e VM na CIMV em comparação ao GC e GO assintomáticos.
Osteoarthritis (OA) is the result of articular cartilage degeneration and is currently considered a common condition with multifactorial causes that affects millions of individuals annually and is one of the principal causes of pain and functional incapacity. The knees are one of the articulations most affected due to the overload that constitutes the principal activator or determinant mechanism for the development of the disease. An in important reduction in movement amplitude and muscular strength occurs that provokes functional limitation and postural alterations, interfering in daily life activities. The main objective of this research was to characterize the postural alterations and electromyographic activity in patients with OA in the knee. This study involved 30 female volunteers, divided into two groups: Control group (CG), composed of 15 elderly women (66.0±4.5 years-old, BMI 25.4±2.29 Kg/m2); and the Osteoarthritis group (OG), composed of 15 elderly women (67.0±5.8 yearsold, BMI 26.2±2.98 Kg/m2), with bilateral radiographic diagnosis of OA of the knees, one symptomatic and one asymptomatic. The SAPO® program was used for postural analysis, based on sagital and frontal plane photographs, which measured the Q angle and angle of the knees bilaterally. Electromyographic evaluation was conducted bilaterally to determine the maximum voluntary isometric contraction (MVIC) of the vastus lateralis and medialis. MVIC was performed with the subjects seated on a bed with the knees at 90º flexion. The subject was asked to perform active extension of the knee against resistance for 5 seconds, repeating this process three times. For statistical analysis, the Shapiro-Wilk test was used for normality, the Levene test for homocedasticity and the Spearman correlation test. Group comparisons were performed by one-way ANOVA. In the OG, the subjects presented severely affected functional capacity (LFI=12) and moderately severe radiological evaluations (Kellgren scale=2), while the CG presented no pain. In the OG, the Q angle was 19.9º for the OA knee and 19.1º for the asymptomatic knee (p=0.732), while in the CG, a Q angle of 19.8º (p=0.955) was obtained for both knees. The intercondylar distance was 2.9 cm for the CG and 5.3 cm for the OG (p=0.168), while the intermalleolar distance was 2.9 cm for the CG and 7.2 cm for the OG (p=0,156). Significant differences occurred in RMS values for the vastus lateralis and medialis in the control knees (VL=545,2±40V / VM=456,9±45V) compared to the symptomatic knees (VL=338,6±54V / VM=291,7±40V) (p=0.001) for both muscles; however, no statistical differences were observed between the control (VL=545,2±40V / VM=456,9±45V) and asymptomatic knees (VL=540,9±19V / VM=443,8±18V). Comparisons between symptomatic (VL=338,6±54V / VM=291,7±40V) and asymptomatic knees (VL=540,9±19V / VM=443,8±18V) showed statistically significant differences in both muscles analyzed (p=0.001 for both). Predominance occurred for valgus knees in both groups with no statistical significance. In the surface electromyography, patients with OA in the knees presented alterations in muscular activity, including diminished MVIC muscular activity in the VL and VM compared to the CG and OG asymptomatic knee.

Introdução: O Transtorno Depressivo Maior (TDM) caracteriza-se por humor polarizado para depressão, diminuição de energia e atividade geral, assim como uma visão distorcida de si, do mundo e do futuro. Os pacientes podem apresentar postura corporal recurvada sem movimentos espontâneos e olhar abatido. Fatores intrínsecos e extrínsecos influenciam a postura corporal do indivíduo, tais como condições físicas do ambiente, estado sócio-cultural e emocional, atividade física e/ou obesidade. A imagem corporal, a qual é a imagem internalizada do próprio corpo, está intimamente ligada à postura. Objetivos: Avaliar a postura e a imagem corporal em pacientes com TDM no episódio depressivo (semana 1) e na remissão total ou parcial (semana 8 a 10), e comparar ao grupo controle. Métodos: Trata-se de um estudo casocontrole observacional com 34 pacientes, com idades entre 37,62 (±8,20), sendo 26(76,5%) do sexo feminino e 8 (23,5%) do sexo masculino, portadores de TDM de acordo com os critérios do DSM IV-TR. O grupo controle é composto de 37 sujeitos sadios do ponto de vista físico e mental, com idade entre 34,78(± 6,21), sendo 29 (78,4%) do sexo feminino e8 (21,6%) do sexo masculino.A avaliação postural foi realizada através da técnica de fotogrametria utilizando um simetrógrafo, com um tripé posicionado a uma altura de 1m e a uma distância de 2,70 m do simetrógrafo, e uma base de apoio posicionada em frente a este, todos nivelados com bolha. Os pontos anatômicos foram identificados e assinalados a partir de palpação dos limites externos dos ossos e foram marcados com adesivos e bolas de isopor de 15 mm, para serem visualizados em vista lateral. O paciente estava vestido em trajes de banho, conforme a técnica de Penha et al. (2005). Foram realizadas fotografias em quatro poses na posição ortostática: frontal(anterior e posterior), sagital (esquerda e direita). Os ângulos e as distâncias entre as referências ósseas foram quantificados em graus e centímetros, respectivamente, e foram calculados com auxílio das linhas traçadas através do software Coreldraw v.12.0, com base nas linhas de referência do simetrógrafo e nos pontos ósseos marcados. Para a avaliação da imagem corporal foi utilizado o questionário Body Shape Questionnaire. Resultados: Houve diferença da postura no grupo depressivo entre a semana 1 (episódio depressivo) e a semanas 8 a 10 (remissão), onde no episódio ocorre, flexão de cabeça sagital direita e esquerda (p<0,001; p<0,001), aumento da cifose torácica direita e esquerda (p<0,001), tendência a abdução da escápula (p=0,046) e tendência a retroversão pélvica( p=0,012). Na comparação entre o grupo controle e o grupo depressivo semana 8-10 houve diferença entre apenas para a variável postura do ombro(p=0,009). Com relação à imagem corporal, houve diferença estatisticamente significativa no grupo de depressivo entre semana 1 e 8-10 (p= 0,007), a pontuação foi de 90,03 (±38,46) na semana 1 e 75,82 (± 35,30) nas semanas 8-10. O grupo controle não apresenta insatisfação com a imagem corporal assim como os pacientes depressivos na remissão. Conclusão: Os resultados mostraram que o paciente depressivo no episódio apresentou alteração da postura com: aumento da cifose, aumento da inclinação anterior da cabeça, tendência a retroversão pélvica e abdução da escápula. Na remissão há melhora desta postura sendo similar ao grupo controle. Com relação à imagem corporal os pacientes depressivos apresentaram insatisfação leve no episódio. Na remissão não há insatisfação com a imagem corporal assim como o grupo controle. Portanto o paciente depressivo apresenta alteração da postura e da imagem corporal devido aos sinais e sintomas do TDM
Introduction: The Major Depressive Disorder (MDD) is characterized by mood polarized for depression, decreased energy and general activity, as well as a distorted vision of itself, the world and the future. Patients may present curved body posture and without spontaneous movements and looking shot. Intrinsic and extrinsic factors influencing the body posture of the individual, such as physical conditions of the environment, state sociocultural and emotional, physical activity and/or obesity. The body image, which is the image of internalised own body, is closely linked to posture. Objectives: To assess the posture and body image in patients with MDD in depressive episode (week 1), and remission (week 8 a 10) in, and compared to control group. Methods: This was an observational case-control study with 34 patients, aged 37.62 (± 8.20), and 26 (76.5%) female and 8 (23.5%) of sex men, diagnostic of TDM according to the criteria of the DSM-IV TR. The control group is composed of 37 healthy subjects from a physical and mental, aged 34.78 (± 6.21), 29 (78.4%) females and 8 (21.6%) of mens. A posture assessment was performed by using a technique of photogrammetry simetrógrafo, with a tripod positioned at a height of 1m and a distance of 2.70 meters from the simetrógrafo, and a base of support positioned in front of him. The anatomical points were identified and marked from palpation of the external limits of the bones and were marked with adhesive dots and small balls to be viewed in side view. The patient was dressed in swim wear, as the technique of Penha et al. (2005). Photographs were taken in four poses in the standing position: front (anterior and posterior), sagittal (left and right). The angles and distances between references bone were measured in degrees and centimeters, respectively, and were calculated with the help of lines drawn through software CorelDraw v.12.0, based on the lines of reference of simetrógrafo and points marked bone. For the evaluation of body image was used questionnaire Body Shape Questionnaire. Results: There was a difference of attitude between the depressive group in week 1 (depressive episode) and 8 to 10 weeks (remission), with : head inclination right and left (p <0001, p <0001), increased of thoracic kyphosis (p <0001), the abduction of the scapula (p=0,046) and tendency to retroversion pelvic (p= 0,012). In the comparison between the control group and the depressed group there was a difference between 8-10 weeks only to the variable position of the shoulder (p = 0009). With regard to body image, there was a statistically significant difference in the group of depression between week 1 and 8-10 (p = 0007), the score was 90.03 (± 38.46) in week 1 and 75.82 (± 35.30) in 8-10 weeks. The control group does not show dissatisfaction with body image and depressive patients in remission. Conclusion: The results showed that patients with depressive episode showed change in the posture with: increased kyphosis, increased head anterior inclination, tendency to retroversion of pelvis abduction and abduction of scapula. In remission there is improvement this attitude is similar to the control group. With regard to body image, patients with mild depressive episode showed dissatisfaction. In remission there is dissatisfaction with body image and the control group. Therefore the patient presents depressing change of posture and body image because of the signs and symptoms of TMD

A boa postura corporal é importante para otimizar a função vocal. Apesar de encontrado o assunto postura e voz na literatura, não foram encontradas pesquisas que estudem os posicionamentos específicos de cabeça e pescoço e como estas influenciam o sinal de voz. O objetivo do presente estudo foi verificar a influência da anteriorização, da posteriorização e da extensão da cabeça no sinal de voz. Foram selecionados 50 homens e 50 mulheres não tabagistas e sem queixas vocais, com idade média de 24,72 e 23,46 anos, respectivamente. Foram demarcados nos participantes três pontos anatômicos: acrômio da escápula, côndilo da mandíbula e processo xifoide do esterno. Os indivíduos foram fotografados sentados em vista lateral com a coluna vertebral ereta simultaneamente ao processo de gravação da vogal /a/ sustentada pelo programa Sound Forge 7.0® em quatro diferentes posturas cervicais: P1) ereta; P2) anteriorização de cabeça; P3) posteriorização de cabeça; e P4) extensão cervical. As posturas foram analisadas por fotogrametria computadorizada pelo programa Corel Draw X3®. As vozes foram estudadas por análise acústica por meio do programa MDVP e por avaliação perceptivo auditiva realizada por três fonoaudiólogos meio de uma escala visual analógica com 100 milímetros de comprimento. A partir dos pontos anatômicos demarcados foram estudados pela fotogrametria os ângulos: côndilo-acrômio (ACA), mento-esternal (AME) e de Frankfurt (AF). Os resultados posturais e vocais foram analisados estatisticamente pelos testes Anova e Tukey com p<0,05. Na fotogrametria, foram encontradas diferenças significantes (p<0,05) em ACA e AME na P2 e P3 em relação à P1 e em AF na P4 quando comparado à P1, para homens e mulheres. Na análise acústica da voz foram encontradas diferenças significantes (p<0,05) na frequência fundamental (F0) na comparação da P2 e P4 em relação à P1 em ambos os grupos, e no shimmer na P4 no grupo das mulheres. Na avaliação perceptivo auditiva foram encontradas diferenças significantes (p<0,05) na comparação da P2 com P1 com pior grau geral, maior tensão e pitch mais agudo para ambos os grupos e maior rugosidade no grupo dos homens na P2. Foi observado na comparação da P3 com P1 diferenças significativas (p<0,05) com pior grau geral, maior tensão, aumento do loudness, pitch mais agudo e maior rugosidade para ambos os grupos na P3. E na P4 foram encontradas pior grau geral, maior tensão, aumento do loudness e pitch mais agudo para ambos os grupos em relação à P1 (p<0,05), e maior rugosidade e soprosidade na P4 (p<0,05) para o grupo dos homens. Conclui-se que pelos achados fotogramétricos que os indivíduos se posicionaram corretamente nas posturas solicitadas. Nas posições da P2, P3 e P4 a voz se torna mais aguda, com maior tensão e com pior qualidade vocal quando comparadas à P1, e em P3 e P4 também se observa o aumento do loudness.
The good corporal posture is important to optimize the vocal function. Although the subject posture and voice has been found in the literature, it wasnt found researches that investigates how the specifics positions of head and neck influence the vocal signal. The aim of the present investigation was to verify the influence of forward head position, backward head position and cervical extension in the vocal signal. It was selected 50 men and 50 women, nonsmokers and without vocal complains, with average age of 24,72 and 23,46 years old, respectively. It was marked in the subjects three anatomic structures: acromion in the scapula, mandibular condyle and xiphoid process in the sternum. The participants were photographed sited in lateral view in a straight spine alignment simultaneously of the recording process of the sustained vowel /a/ by the program Sound Forge 7.0® in four different cervical postures: P1) straight alignment; P2) forward head position; P3) backward head position; and P4) cervical extension. The postures were analyzed by photogrammetry by the Corel Draw program. The voice were studied by acoustic analysis by the MDVP program and by perceptual speech analysis done by three speech therapists using a visual analogue scale with 100 millimeters of length. From the anatomic structures marked were studied by photogrammetry the angles: condyle-acromion (ACA), menton-sternum (AME) and Frankfurt (AF). The postural and vocal results were statistically analyzed by the Anova and Tukey tests with p<0,05. In the photogrammetry, were found significant differences (p<0,05) in ACA and AME in P2 and P3 in relation to P1 and in AF in P4 when compared to P1, for both men and women. IN the acoustic analysis were found significant differences (p<0,05) in fundamental frequency (F0) in the comparison of P2 and P4 with P1 in both groups, and in shimmer in the P4 for the women group. In the perceptual speech analysis were found significant differences (p<0,05) ) in the comparison of P2 with P1 with worse general degree, increased tension and pitch more acute for both groups and increased roughness for the men group in the P2. It was observed in the comparison of P3 with P1 significant differences (p<0,05) with worse general degree, increased tension, increased loudness, pitch more acute and increased roughness for both groups in P3. And in P4 were found worse general degree, increased tension, increased loudness and pitch more acute for both groups and increased roughness and breathiness in P4 (p<0,05) for the men group. It can be concluded by the founds in photogrammetry that the subjects were correctly positioned in the postures solicited. IN the P2, P3 and P4 positions the voice become more acute, with more tension and worse quality when compared to the P1 position, and also in P3 and P4 can be observed increased loudness.

Background: Improving habitual sitting posture in office environment has beneficial effectson behaviour changes and reduces the risk of musculoskeletal symptom. There are different treatments to improve habitual sitting posture, one is kinesiology tape. However, studies on kinesiology tape do not confirm if tape is a valid treatment on postural control, improvingmuscular function, or releasing pain. What physiological mechanism is behind kinesiologytape is also unclear. A hypothesis is that kinesiology tape affects postural control by mechanoreceptors. Balancing body tape is a new type of postural tape with similar qualities as kinesiology tape. Aim: The aim was to investigate the effects of a three-week Balance body tape-treatment onhabitual sitting posture, assessed as the thoracic angle and the cervical angle, during a six minute computer work session. Method: Twenty-six subjects completed the RCT study, 12 were in the intervention group, 14 were in the control group (non-treated subjects). A questionnaire and a photographic postureanalysis method was conducted to investigate the subjects thoracic- and cervical angle beforeand after a three-week intervention with Balancing body tape compared with a control group. Paired sample and independent sample t-test was conducted to examine the mean angular difference and the changes between starting position and angular change from minutes 2-6, both in and between the two groups. Result: There was a statistically significant improvement in the mean thoracic angle of the intervention group after posture treatment with 6° decrease (p = 0.008), while no significantimprovement was found in the cervical angle (p = 0.058). No significant difference was foundbetween the intervention group and the control groups thoracic or cervical angle (p=0.151 - p=0.937). There was a 5° thoracic angle difference in the ability to maintain an upright sittingposture between the two groups in the baseline data (p=0.004). However, the ability to maintain an upright sitting posture during 6-minute computer work was not changed, either in the intervention group or between the groups. Conclusion: These founding’s suggest that the Balancing body tape has a small impact on subject’s thoracic angle in sitting posture after a three-week intervention. But compared witha control group no significant difference was established in mean angular, which reduces thecredibility that the Balancing body tape has an impact on thoracic angle in sitting posture. Further studies are required during a longitudinal randomised control trail to establish a scientific result.

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This descriptive study aimed validating the postural evaluation system and to evaluate the posture of the cervical and thoracic spine area in the sagittal plan with the level of physical activity of elderly people. The sample was composed by 72 people (elderly), being 55 women and 17 men, with average age of the 69,19 years old (_=6,63), all of them belonged to Third Age Group from the Universidade Estadual de Santa Catarina UDESC. The instruments for data collection were: interview and the IPAQ (International Physical Activity Questionnaire, version 8). A posture assessment system was elaborated for this study, setting up a Rotative Platform for Postural Assessment (PGAP), and also using a camera, a calibration stand and specific software; the instruments were applied individually. Data were tabulated and stored in the statistical package Statistica version 6.0, and the Pearson s Correlation Coefficient, chi-square and Student s t test were used, with a significance level of p <0,05. Fifty three of these people had age between 60 and 74 years old (young elderlies) and nineteen above to 75 (old elderlies). Most of them could be considered active physically (98,6%). Older women were more active than men. The sitting time average ( =1.876 min/sem) was superior than time spent in physical activity ( =1.732 min/sem). Young elderlies were more active ( =1.136 min/sem.) that the oldest ones ( =825 min/sem.). Younger elderlies were more active than old ones. The cervical% index average was 37,5 and the thoracic% one, 15,9. According the statistical tests, there was no significant statistically relationship between these both variables. The women presented larger cervical% index (38,4) that the men (34,5) and smaller thoracic% index (15,7 and 16,4, respectively). The youngest showed a larger cervical% (38,7) and thoracic% (15.9) index than the oldest ones (34,0 and 15,7). There was significant difference (t test) between cervical% index and age classification (p=0,0598). The apex of the cervical and thoracic for all the people was placed in the superior part of the curvature. The thoracic apex and index presented significant statistically correlation (r=0,23). It is ended that: There is no relationship between the physical activity and cervical and thoracic postures in this study. High levels of physical activity were associated to high indexes of kyphosis. This work concluded that: the evaluation system proposed got successfully with a huge applicability. The indexes proposed to measure posture of the cervical and thoracic spine area showed finely the curves characteristics. Elderly with a higher physical activity are related to more accentuated curves in the thoracic area.
Este estudo de cunho descritivo-diagnóstico teve como objetivo principal validar o sistema de avaliação postural e avaliar a postura (região cervical e torácica no plano sagital) de idosos com diferentes níveis de atividade física. Participaram do estudo 72 idosos, sendo 55 mulheres e 17 homens, com média de idade de 69,19 anos (_=6,63), pertencentes ao Grupo de Estudos da Terceira Idade (GETI) da Universidade do Estado de Santa Catarina (UDESC). Os instrumentos para a coleta de dados foram: entrevista contendo ficha de identificação (nome, sexo, idade, estatura) e o IPAQ (Questionário Internacional de Atividade Física, versão 8, forma longa e semana normal), que avalia o nível de atividade física. Para este estudo foi elaborado um sistema de avaliação da postura, com a construção da Plataforma Giratória para Avaliação Postural (PGAP), usou-se também filmadora, suporte de calibração e software específico. Os instrumentos foram aplicados aos idosos individualmente. Os dados foram tabulados e armazenados no pacote estatístico Statistica versão 6.0, usou-se os testes de Correlação de Pearson, Qui Quadrado e t Student, adotando-se um nível de significância de p<0,05. Dos 72 idosos avaliados, 53 eram idosos jovens (60 a 74 anos) e 19 idosos idosos (acima de 75 anos). A maior parte dos idosos pôde ser considerada fisicamente ativa (98,6%). As mulheres idosas eram mais ativas que os homens. A média do tempo sentado ( =1876 min/sem) foi superior ao tempo realizando atividade física ( =1732 min/sem). Idosos jovens eram mais ativos ( =1136 min/sem.) que os idosos idosos ( =825 min/sem.). A média do índice da cervical% foi de 37,5 e da torácica% de 15,9. Segundo testes estatísticos não houve relação significativa entre estas variáveis. As mulheres apresentaram maior índice cervical% (38,4) que os homens (34,5) e menor índice torácico% (15,7 e 16,4, respectivamente). Os mais jovens apresentaram índices maiores para a cervical% (38,7) e torácica% (15,9) que os mais velhos (34,0 e 15,7). Houve diferença significativa (teste t) para o índice da cervical% e a classificação etária (p=0,0598). O ápice da curva cervical e torácica para todos os idosos estava situado na parte superior da curvatura. O ápice da torácica e o índice da torácica% apresentaram correlação estatisticamente significativa (r=0,23). Quanto mais acentuada a torácica mais superior, na curva, está o ápice. Não se observou relação entre o nível de atividade física e os valores dos índices da cervical%. Porém observou-se para a torácica. Índices mais elevados de cifose estavam associados a níveis mais elevados de atividade física. Conclui-se que: O sistema de avaliação postural construído atendeu as necessidades do estudo, e mostrou-se de fácil aplicabilidade, e seguro para os idosos. Os indicadores propostos para medição das regiões cervical e torácica possibilitaram demonstrar a magnitude e características das curvas. Idosos mais ativos estão relacionados a curvas mais acentuadas na região torácica.