Serratus anterior sEMG – sensor placement and test position for normalization purposes during maximal and submaximal exertions

There is great variability regarding serratus anterior sEMG sensor placement and test positions during normalization procedures. We investigated between-trials reliability of serratus anterior sEMG, acquired at two sensor placements and four test positions, during maximal and submaximal isometric contractions. Twenty young healthy women participated. sEMG was captured at the 7th intercostal space and at the xiphoid process level, in the mid-axillary line, during maximal and submaximal isometric contractions, in four test positions. Intraclass Correlation Coefficient (ICC2,1), coefficient of variation and standard error of measurement were calculated. Interactions between sensor placements and test positions were investigated using a two-way repeated-measures ANOVA. All test conditions presented ICC2,1 > 0.8. There was no interaction between sensor placement and test position. Signal obtained from the sensor at 7th intercostal space was more stable between-trials and showed higher amplitude, during maximal and submaximal contractions, at seated positions with shoulder protracted at both 90° or 125° of flexion. We suggest to acquire serratus anterior sEMG at the 7th intercostal space and perform maximal or submaximal isometric contractions for signal normalization with shoulder protracted and flexed, at seated position

Shoulder-specific rehabilitation combined with aerobic exercises versus solely shoulder-specific rehabilitation in patients with type 2 diabetes mellitus : study protocol for a randomized controlled superiority trial

Background: Musculoskeletal disorders are very common in patients with diabetes mellitus (DM). The upper limb is one of the regions that is most frequently affected generally presenting limited joint mobility, pain, and a decreased muscle strength. Most clinical trials with a focus on shoulder musculoskeletal rehabilitation are carried out in patients who do not present DM. Thus, the purpose of the present study is to compare the effects of two distinct treatment protocols (conventional shoulder musculoskeletal rehabilitation combined with aerobic exercises versus solely conventional shoulder musculoskeletal rehabilitation) on shoulder pain, function, strength, kinematics, and supraspinatus tendon thickness in patients with type 2 DM after 12 weeks of intervention and a subsequent follow-up at week 20. Methods: A randomized controlled superiority trial will be conducted. Participants with a clinical diagnosis of type 2 DM of both sexes, age between 40 and 70 years, presenting shoulder pain will be randomly assigned to one of the following groups: (1) conventional shoulder musculoskeletal rehabilitation combined with aerobic exercises; (2) solely conventional shoulder musculoskeletal rehabilitation. All individuals will be evaluated before starting the treatment protocol (baseline) and at the end of treatment (post 12 weeks) and as a follow-up at 20 weeks. The shoulder function assessed by the SPADI (Shoulder Pain and Disability Index) questionnaire will be considered as primary outcome; the secondary outcome will be shoulder pain, measured with NPRS scales. Other outcomes will include range of motion, measured using a digital inclinometer; isometric shoulder muscle strength, measured using a manual muscle dynamometer; shoulder kinematics, measured using three-dimensional inertial units measurement; supraspinatus tendon thickness, measured using an ultrasound; AGE accumulation, using a skin autofluorescence measurement; and HbA1c (hemoglobin a1c), fasting glucose and lipid profile measured by a simple blood test. Discussion: DM is a highly prevalent disease and a public health problem worldwide, and the upper extremity musculoskeletal disorders in DM are barely recognized and largely underestimated. In this way, it would be interesting to analyze if the combination of aerobic exercises with conventional musculoskeletal rehabilitation protocols could generate better results in the functionality, pain, mobility and an improvement in the biochemical aspects related to the hyperglycemia of these patients compared to solely the conventional musculoskeletal rehabilitation

Modelo de autoavaliação para suporte à gestão organizacional: experimentação em indústria do segmento de malharia Model of self-evaluation to support organizational performance: experiment performed in knitted fabric textile industry

Este trabalho apresenta um modelo para suporte à gestão organizacional com foco em autoavaliação fundamentado nos critérios dos principais prêmios de excelência em gestão internacionais e do Brasil. Esta proposta teve por finalidade permitir avaliações personalizadas de desempenho do sistema de gestão e da importância para a organização das práticas de excelência em gestão preconizadas por tais prêmios. O método de pesquisa constituiu-se em fundamentação teórica, análise comparativa de três dos principais prêmios de excelência em gestão internacionais e do Brasil e experimentação do modelo proposto em uma indústria do segmento de malharia. A aplicação do modelo proposto possibilitou uma avaliação personalizada do desempenho do sistema de gestão da organização objeto de estudo e, também, da importância atribuída às práticas de excelência em gestão abordadas nos critérios. O contraste entre desempenho e importância permitiu a identificação de pontos organizacionais prioritários de melhoria da organização.<br>This project aims to present a sample to support organizational management focusing on self-evaluation based on the criteria of the most important international and national excellence awards in management. The objective of the sample was to allow for customized evaluations of performance regarding the management system as well as evaluations of the importance of management excellence practices to the company preconized by those awards. The research methodology was based on a theoretical foundation, comparative analysis of the three main Excellence Awards in Management in Brazil, and on the experiment of the sample proposed in a knitted fabric textile industry. The sample proposed has allowed for a customized performance evaluation of the management system of the company used as the object of study, and the importance of the management excellence practices involved in the criteria. The contrast between performance and importance has allowed defining the major organizational aspects aiming at the company's improvement