Front crawl arm stroke trajectories of physically impaired swimmers: A preliminary study

© 2019 Elsevier Masson SAS. Introduction: This study evaluated three-dimensional kinematic parameters of the front crawl stroke in physically impaired swimmers across a range of functional classification levels. Facts and Results: Eight highly-trained competitive swimmers (5 male and 3 female) from IPC classes S5 to S9 performed 50 m maximal front crawl trials while being video-taped by six cameras (four under- and two above water). The most distal point of the right upper limb was manually digitised at 50 Hz to allow three-dimensional reconstruction of the limb's trajectory through the water. Conclusion: The stroke presented large inter-swimmer variability, reflecting individual characteristics and severity of the impairment. The swimmers who combined shallow and narrow stroke movements produced a shorter trajectory. This study provides swimmers and coaches with an overview of the kinematic characteristics of a range of physically impaired swimmers

Antecedente de vida rural ou de vida urbana e doença de Parkinson

Although the precise etiology of Parkinson's disease (PD) is as yet unknown, it appears that certain environmental factors are involved. Prior living in a rural area has been implicated as a possible risk factor for PD, particularly in the early onset type. We evaluated the role of previous living conditions in the clinical correlates and outcome characteristics of 118 PD patients. All of them were seen from January 1987 to October 1992. The Rural Group (RG) comprised 71 patients (60.2%) who had lived in the rural area for at least 10 years (mainly in early phase of life) and the Urban Group (UG) consisted of 47 patients (39.8%) who had lived their entire life in an urban environment. The average age at the beginning of the symptoms was 58.8 in the RG and 54.1 in the UG. The mixed form of the disease (tremor, rigidity and akinesia) was the most frequent in both groups. A minimum 6-month follow-up period was undertaken with 63 patients (average 20 months) and no difference in response to treatment or in progression of the illness was detected between the two groups. Our data show that the previous living environment does not appear to be a determining factor in either the clinical or outcome characteristics of PD.A etiologia da doença de Parkinson (DP) é ainda desconhecida mas parece que fatores ambientais podem estar envolvidos. A incidência da DP, particularmente a de início precoce, parece ser maior em indivíduos com antecedente de moradia na zona rural. Avaliamos as características clínicas e a progressão da DP em 118 pacientes segundo os antecedentes de área de moradia pregressa. Havia 71 pacientes (60,2%) com antecedente de no mínimo 10 anos na zona rural (especialmente nas fases iniciais da vida), o chamado Grupo Rural (GR), e 47 pacientes (39,8%) que tiveram antecedente de vida exclusivamente urbana, o chamado Grupo Urbano (GU). A média de idade de início dos sintomas foi 58,8 anos no GR e de 54,1 anos no GU. A forma mista da DP (com tremor, bradicinesia e rigidez) foi a mais frequente em ambos os grupos. Um período de acompanhamento de no mínimo 6 meses foi obtido em 63 pacientes (média de 20 meses de acompanhamento) e a progressão da sintomatologia foi semelhante nos dois grupos (GR e GU). Nossos dados indicam que o antecedente de moradia não parece ser determinante para o padrão de manifestação clínica e de evolução da DP.Universidade Federal de São Paulo (UNIFESP) Department of Neurology and Neurosurgery Movement Disorders UnitUniversidade de São Paulo Faculdade de Medicina Department of Neurology, Psychiatry and Medical PsychologyUNIFESP, Department of Neurology and Neurosurgery Movement Disorders UnitSciEL

CONSTRUCTION OF SENSOR INSOLES FOR PRESSURE AND TEMPERATURE MEASUREMENT

Plantar pressure measurements are used to quantify static and dynamic pressures as a measure of foot function during gait1. In spite several technologies of plantar pressure measurement have been developed in the last years1, most are costly specialized equipments that present some limitations, such as short life time (corrosion or damage of the base circuit during use), operational complexity and measurement errors caused by the (high) thickness of sensor insoles. In addition, concomitant measurement of temperature is not possible at commercial equipments. This work describes the development of a sensor insole system for the measurement of plantar pressure and temperature, in real time

Avaliação das anomalias clínico-funcionais na doença de Pompe: Relato de Caso

The patient was a 15 year-old girl who turned out at the Physical Therapy Clinic presenting progressive scoliosis and angle of 50º Coob by X-Ray. She complained of back pain, headache and weakness of shoulder and pelvid girdle. Physical therapy evaluation came across features of delayed motor development and undermourishment, together with generalized muscle weakness (grade=4) which was observed by the Kendall test. Lung vital capacity was 40,5%. Clinical Changes: studies of the enzymes with acid alpha-glucosidase assay kits used on filter and leukocytes low enzyme activity, suggesting a late form of the Pompe disease. The molecular studies proved that the patient had a mutation associated with late-onset Pompe disease. Acid alpha-glucosidase enzyme assay studies performed in skin fibroblasts showed a reduction of the enzymatic acitivity of the acid alpha-glucosidase, confirming the previous results. On account of the results, Pompe disease induced important changes in clinical and functional, as well as metabolic changes, decreased strength and muscle action potentially, biomechanical changes in the spine and changes in respiratory capacity. Furthemore, this case of Pompe disease illustrates the importance od adequate physical therapy evaluation as it can be the starting point of investigation of serious conditions such as late onset Pompe disease.Paciente do sexo feminino com 15 anos, apresentou-se na Clínica de Fisioterapia, devido à presença de escoliose progressiva com ângulo de Coob de 50º pelo Raio-X. Apresentou queixa de dor na coluna e na cabeça, fraqueza de cintura escapular e pélvica. Na avaliação fisioterapêutica observou-se um quadro semelhante ao atrado do desenvolvimento motor e desnutrição, com fraqueza muscular generalizada (grau=4) observada pelo teste de Kendall. Na função pulmonar a capacidade vital apresentou com 40,5%. Estudos enzimáticos com dosagem da alga-glicosidade ácida em papel-filtro e leucócitos evidenciaram baixa atividade enzimática, sugestivo de forma tardia da doença de Pompe. No estudo molecular, comprovou-se que a paciente possuía mutação associada à forma tardia da doença: estudos enzimáticos da alfa-glicosidade ácida em fibroblastos cultivados a partir de biópsia de pele evidenciaram redução da atividade enzimática da alga-glicosidase ácida, confirmando estudos enzimáticos prévios. Perante os resultados, a doença de Pompe apresentou alterações clínicas e funcionais importantes como alteração do metabolismo, diminuição de força e do potencial de ação da musculatura, alterações biomecânicas na coluna e na capacidade respiratória. Adicionalmente, o caso ilustra a importânica da avaliação fisioteraupêtica adequada, pois ele pode ser o ponto de partida da investigação de doenças graves como o presente caso

Glass-ceramic Flexural Strength after Hydrofluoric Acid and Unfilled Resin Treatment

poster abstractThe use of hydrofluoric (HF) acid is considered one of the most effective methods for achieving durable resin bond to glass-ceramics. Nonetheless, HF acid etching effect on glass-based ceramics strength remains uncertain and only a few contradictory studies have reported the influence of an unfilled resin (UR) application on the ceramic strength. Objectives: To investigate the effect of HF acid etching followed by silane and UR applications on the biaxial flexural strength of a nanofluorapatite glass-ceramic. Methods: 144 disc-shaped (15±1mm in diameter and 0.8±0.1mm in thickness) nanofluorapatite ceramic specimens were allocated into 12 groups: G1-control (no etching), G2-30s, G3-60s, G4-90s, G5-120s, G6-60s+60s. Meanwhile, G7-G12 were treated in the same fashion as G1-G6, but followed by silane and UR applications. Surface morphology of G1-G12 was assessed by scanning electron microscopy/SEM. The flexural strength was determined by biaxial testing per ISO 6872. Statistical analyses were two-way ANOVA and the Sidak multiple comparisons procedure (α=0.05). Additionally, Weibull statistics and finite element analysis (FEA) were carried out. Results: A significant effect of etching time (p=0.0290) on flexural strength was observed. G4 led to a significantly (p=0.0392) higher flexural strength than G1. Correspondingly, G10 revealed a considerably higher flexural strength than G7 (p=0.0392). Furthermore, flexural strength was significantly higher for G7-G12 than for G1-G6 (p<0.0001). For G1-G6, G4 showed the highest Weibull characteristic strength and G10 also presented the highest Weibull characteristic strength among G7-G12. FEA showed lower stress concentration in G7-G12 with the gradient stress supporting the fracture types of the biaxial test. Finally, the SEM data revealed that the HF acid etching affected the surface of ceramic specimens by generating pores and irregularities and more importantly that the UR was able to penetrate into the ceramic microstructure. Conclusions: HF acid etching followed by silane and UR applications enhanced the ceramic biaxial flexural strength

ALGOMETER FOR ASSESSING PRESSURE PAIN THRESHOLDS

Muscular and joint injuries and localized pain can be occasioned during sports practice. Although the reliability of palpation techniques (to evaluate muscle and joint tenderness) has improved and algometers have been developed1, they do not simulate the palpation technique and real time measurements are not possible. A new pressure algometer to determine pressure pain thresholds in real time has been developed, to be used in diagnosis and injury treatment evaluation of athletes

Postural tremor and dystonia: clinical correlates and pathophysiological considerations

The coexistence of tremor and dystonia is usually seen but there is not a satisfactory explanation for it. Some consider that essential tremor (ET) and idiopathic dystonia (ID) may be genetically linked. To clarify this relationship we evaluated the frequency of postural hand tremor in ID and symptomatic dystonia (SD) patients. We studied the records of patients with dystonia seen in our Movement Disorders Unit. ID was considered when there was no other neurological abnormality in the examination aside from dystonia, normal laboratorial tests and neuroimaging related to dystonia, and a negative past history for any known cause for it, except for genetic predisposition. We analyzed the clinical characteristics of dystonia and the occurrence of postural tremor. We collected 185 patients, being 120 with ID and 65 with SD. Tremor was seen in 27 (22.5%) of ID and 14 (21.5%) of SD. Tremor was present in either focal, segmental or generalized dystonia in both ID and SD. Family history for ET was absent in all patients. The similar frequency of tremor in ID and SD patients suggests that the pathophysiologic derangement resulting in dystonia can favor the development of tremor.A presença de tremor e distonia de torção no mesmo paciente é frequente mas não há uma explicação satisfatória para isso. Suspeita-se que haja uma associação da distonia idiopática (DI) com o tremor essencial (TE). O objetivo deste estudo é analisar a frequência de tremor postural das mãos em pacientes com DI e distonia sintomática (DS). Foram estudados os prontuários de 185 pacientes com o diagnóstico sindrômico de distonia atendidos no Setor de Investigação em Moléstias Extrapiramidais da Escola Paulista de Medicina. DI foi diagnosticada quando não havia anormalidade no exame neurológico além da distonia e havia exames laboratoriais e de neuroimagem, relacionados à distonia, normais e história pregressa negativa para fatores causais de distonia. Foram analisadas as características clínicas da distonia e a presença de tremor postural nas mãos. Havia 185 pacientes, 120 com DI e 65 com DS. Tremor postural das mãos ocorreu em 27 (22,5%) das DI e 14 (21,5%) das DS. Tremor esteve presente nos quadros focais, segmentares e generalizados e também nos diversos tipos clínicos de DI e DS em proporções semelhantes. História familiar de TE estava ausente em todos os casos com tremor. A presença de tremor postural das mãos em pacientes com DI e DS pode sugerir que a desorganização fisiopatológica que produz a distonia pode favorecer o aparecimento do tremor.Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Escola Paulista de MedicinaUNIFESP, EPMSciEL

Factors associated with the prescription of vaginal pessaries for pelvic organ prolapse

OBJECTIVE: To identify the factors associated with the prescription of vaginal pessaries (VPs) as a conservative treatment for pelvic organ prolapse (POP). METHODS: A cross-sectional study was performed during two annual urogynecology and general obstetrics and gynecology meetings in 2017 (Sa˜o Paulo, SP, Brazil). A 19-item deidentified questionnaire regarding experiences and practices in prescribing VPs for POP patients was distributed among gynecologists. Our primary outcome was the frequency of prescribing VPs as a conservative treatment for POP. The reasons for prescribing or not prescribing VPs were also investigated. Univariate and multivariate analyses with crude and adjusted odds ratios (ORs) were performed for variables associated with the prescription of pessaries. RESULTS: Three hundred forty completed surveys were analyzed. Half of the respondents (53.53%) were between 30-49 years old; most of them were female (73.53%), were from the Southeast Region (64.12%), were trained in obstetrics and gynecology (80.24%) or urogynecology (61.18%) and worked in private offices (63.42%). More than one-third (36.48%) attended four or more POP cases/week, and 97.65% (n=332) had heard or knew about VPs for POP; however, only 47.06% (n=160) prescribed or offered this treatment to patients. According to the multivariate analysis, physicians aged 18-35 years (OR=1.97[1.00-3.91]; p=0.04), those who participated in a previous urogynecology fellowship (OR=2.34[1.34-4.09]; po0.01), those with relatively high volumes of POP cases (4 or +) (OR=2.23[1.21-4.47]; p=0.01) and those with PhD degrees (OR=2.75[1.01-7.54]; p=0.05) prescribed more pessaries. CONCLUSIONS: Most gynecologists did not prescribe VPs. Younger physician age, participation in a previous urogynecology fellowship, a PhD degree, and a relatively high volume of POP cases were associated with increased VP prescription rates