Influência da idade e do sexo na força isométrica do joelho e do quadril de indivíduos jovens e de meia idade praticantes recreacionais de atividades físicas

Muscle strength is an essential part of thefunctional assessment of health professionals to selectand analyze the effects of clinical interventions. This studyaimed to determine the influence of gender and age onisometric strength of hip and knee muscle groups. A totalof 127 subjects (50.4% men), aged from 20 to 49 years(stratified into three groups: 20–29 years; 30–39 years;and 40–49 years) participated in this study. A hand-helddynamometer was used to measure isometric normalizedtorque of the hip abductors, hip external rotators,knee extensors, and knee flexors muscles. Regressionsand a two-way analysis of variance were used to identifythe influence of age and gender on torque of each musclegroup. Age and gender were included in the regression model for all groups. Generally, men aged 20–29 and 30–39 werestronger than age-paired women. For participants aged 40–49,torque was similar for men and women for all muscle groups.There was no difference among age groups for women. Generally,young men were stronger than older men. The associationbetween age and gender in hip and knee strength was provedand liable of subgroup stratification after measurements with ahand-held isometric dynamometer| La fuerza muscular es un componente básico dela evaluación funcional de los profesionales de la salud paraseleccionar y analizar los efectos de las intervenciones clínicas.El objetivo de este estudio fue determinar la influencia del sexo yde la edad en las mediciones de fuerza isométrica de los gruposmusculares de la cadera y la rodilla. En el estudio participaron127 sujetos (50,4% hombres), de entre 20 y 49 años de edad(estratificados en grupos: 20 a 29 años; 30 a 39 años; y 40 a 49 años).El torque isométrico normalizado de los abductores y rotadoresexternos de la cadera y de los extensores y flexores de la rodilla semidió con un dinamómetro manual. Se utilizaron regresiones y elanálisis de varianza (Anova) para identificar la influencia de la edady el sexo en el torque. Tanto la edad como el sexo se incluyeron en elmodelo para todos los grupos musculares. En general, los hombresde entre 20 y 29 años y los de 30 a 39 mostraron tener más fuerzaque las mujeres del mismo grupo de edad. Para los participantesde 40 a 49 años, el torque fue similar entre hombres y mujeres paratodos los grupos musculares. No hubo diferencias entre los gruposde edad en el grupo de mujeres. En general, los hombres más jóvenesdemostraron ser más fuertes que los hombres de mediana edad.La relación entre la edad y el sexo en la fuerza muscular de la caderay la rodilla se probó y demostró ser susceptible a la estratificacióndespués de las mediciones realizadas con el dinamómetro manual.A força muscular é um componente essencialda avaliação funcional de profissionais da saúde paraselecionar e analisar efeitos de intervenções clínicas.O objetivo do estudo foi determinar a influência do sexoe da idade sobre medidas de força isométrica de gruposmusculares do quadril e do joelho. Participaram da pesquisa127 sujeitos (50,4% homens), com idade de 20 a 49 anos(estratificados em grupos: 20 a 29 anos; 30 a 39 anos; e 40 a49 anos). O torque isométrico normalizado de abdutorese rotadores externos de quadril e extensores e flexores dejoelho foi medido com dinamômetro manual. Regressõese uma análise de variância (Anova) foram usados paraidentificar a influência da idade e do sexo sobre o torque.Tanto idade quanto sexo foram incluídos no modelo paratodos os grupos musculares. Em geral, homens de 20 a29 anos e de 30 a 39 anos demonstraram mais força doque mulheres da mesma faixa etária. Para participantes de40 a 49 anos, o torque foi similar entre homens e mulherespara todos os grupos musculares. Não houve diferençaentre as faixas etárias no grupo de mulheres. Em geral,homens mais jovens se mostraram mais fortes do quehomens mais velhos. A relação entre idade e sexo na forçamuscular do quadril e do joelho foi provada e se mostroupassível de estratificação após as medições feitas com odinamômetro manual

Motor coordination during gait after anterior cruciate ligament injury: a systematic review of the literature

AbstractTo investigate the state of art about motor coordination during gait in patients with anterior cruciate ligament (ACL) injury. Searches were carried out, limited from 1980 to 2010, in various databases with keywords related to motor coordination, gait and ACL injury. From the analysis of titles and applying the inclusion/exclusion criteria 24 studies were initially selected and, after reading the abstract, eight studies remained in the final analysis. ACL deficient patients tend to have a more rigid and less variable gait, while injured patients with ACL reconstruction have less rigid and more variable gait with respect to healthy individuals. The overall results suggest the existence of differences in motor coordination between the segments with intact and those with injured knee, regardless of ligament reconstruction. ACL injured patients present aspects related to the impairment of the capability to adapt the gait pattern to different environmental conditions, possibly leading to premature knee degeneration. However, the techniques used for biomechanical gait data processing are limited with respect to obtaining information that leads to the development of intervention strategies aimed at the rehabilitation of that injury, since it is not possible to identify the location within the gait cycle where the differences could be explained

Acromial type in Brazilian young adults: a radiological study

Introduction: Acromion curved and hooked play a key role in shoulder impingement syndrome. Little is known about the acromial type in Brazilian population. Aim: To describe the acromial type profile in Brazilian young adults; to evaluate its correlation to gender and handedness and the occurrence of symmetry between genders. Methodology: Forty acromions of 20 Brazilian adults, both genders, between 21-25 years old were studied. The acromion type was classified by Bigliani/Epstein method by supraspinatus outlet view radiographs. Results: As there was no gender difference in the occurrence of acromial type, we considered male and female groups together. Thus, of the 20 right acromions, we found 5 (25%) type I, 8 (40%) type II and 7 (35%) type III. Of the 20 left acromions, we found 4 (20%) type I, 11 (55%) type II and 5 (25%) type III. The only left-handed volunteer (100%) presented for the right and left shoulder acromial type III. Of the 19 right-handed volunteers, 5 (26.3%) presented right acromion type I, 8 (42.1%) type II, and 6 (31.6%) type III; for the left acromion, 4 (21.1%) presented type I, 11 (57.9%) type II, and 4 (21.1%) type III. Acromial symmetry occurred in female (60%) and male (70%) groups. Conclusion: Type II acromion was the most predominant for right and left shoulder in Brazilian young adults. There was no correlation between acromial type and gender. It was not possible to analyze the correlation between acromial type and handedness. Acromial type tends to be symmetric in our sample

Confiabilidade interavaliador do método de Bigliani para classificação do tipo acromial

Introdução: em 1875, Hamilton identificou o formato do acrômio como uma etiologia de dor no ombro. Neer, em 1972, descreveua síndrome do impacto no ombro como uma relação de causa e efeito entre a morfologia do acrômio e o impacto subacromial. Em1986, Bigliani et al. apresentaram um esquema de classificação do acrômio de acordo com o formato de sua superfície inferior:plano (tipo I), curvo (tipo II) e gancho (tipo III). Em 1993, Epstein et al. proporam que o acrômio tipo II apresentaria um declive emseu terço médio e o tipo III no seu terço anterior. Objetivo: avaliar a reprodutibilidade/confiabilidade interavaliador do método de Bigliani et al. (1986) refinado por Espstein et al. (1993) para a classificação do tipo acromial. Metodologia: casuística composta por 20 voluntários brasileiros, de ambos os gêneros, entre 21-25 anos. A incidência radiográfica utilizada para visualizar o formato do acrômio foi perfil de escápula. O tipo acromial foi classificado por três avaliadores. A reprodutibilidade e confiabilidade foram avaliadas pelo teste McNemar e pelo índice Kappa. Resultados: teste de McNemar com p > 0,05; índice Kappa entre 0,61 e 0,8; e probabilidade de significância p de Kappa < 0,05 confirmam a muito boa reprodutibilidade e confiabilidade do método para classificação do tipo acromial entre os três avaliadores. Conclusão: o método de Bigliani et al. (1986) refinado por Epstein et al. (1993) para classificaçãodo tipo acromial mostrou concordância entre todos os avaliadores confirmando a muito boa reprodutibilidade e confiabilidade entre os avaliadores do estudo

Secondary infections in a cohort of patients with COVID-19 admitted to an intensive care unit: impact of gram-negative bacterial resistance

Some studies have shown that secondary infections during the COVID-19 pandemic may have contributed to the high mortality. Our objective was to identify the frequency, types and etiology of bacterial infections in patients with COVID-19 admitted to an intensive care unit (ICU) and to evaluate the results of ICU stay, duration of mechanical ventilation (MV) and in-hospital mortality. It was a single-center study with a retrospective cohort of patients admitted consecutively to the ICU for more than 48 h between March and May 2020. Comparisons of groups with and without ICU- acquired infection were performed. A total of 191 patients with laboratory-confirmed COVID-19 were included and 57 patients had 97 secondary infectious events. The most frequent agents were Acinetobacter baumannii (28.9%), Pseudomonas aeruginosa (22.7%) and Klebsiella pneumoniae (14.4%); multi-drug resistance was present in 96% of A. baumannii and in 57% of K. pneumoniae. The most prevalent infection was ventilator-associated pneumonia in 57.9% of patients with bacterial infections, or 17.3% of all COVID-19 patients admitted to the ICU, followed by tracheobronchitis (26.3%). Patients with secondary infections had a longer ICU stay (40.0 vs. 17 days; p < 0.001), as well as a longer duration of MV (24.0 vs 9.0 days; p= 0.003). There were 68 (35.6%) deaths overall, of which 27 (39.7%) patients had bacterial infections. Among the 123 survivors, 30 (24.4%) had a secondary infections (OR 2.041; 95% CI 1.080 - 3.859). A high incidence of secondary infections, mainly caused by gram-negative bacteria has been observed. Secondary infections were associated with longer ICU stay, MV use and higher mortality

Effect of the Combined Intervention with Passive Whole-Body Vibration and Auriculotherapy on the Quality of Life of Individuals with Knee Osteoarthritis Assessed by the WHOQOL-Bref: A Multi-Arm Clinical Trial

The aim of this study was to determine the effect on the quality of life of two non-pharmacological interventions isolated or in combination: (i) passive whole-body vibration exercise (WBVE), and (ii) auriculotherapy (AT). One hundred three participants with knee osteoarthritis (KOA) were allocated to: (a) a vibration group (WBVEG; n = 17) that performed WBVE (peak-to-peak displacement: 2.5 to 7.5 mm, frequency: 5 to 14 Hz, Peak acceleration: 0.12 to 2.95 g), two days/weekly for five weeks, (b) an AT group (ATG; n = 21), stimulation of three specific auriculotherapy points (Kidney, Knee and Shenmen) in each ear pavilion, (c) WBVE + AT (WBVE + AT; n = 20) and (d) respective control groups (WBVE_CG, n = 15; AT_CG, n = 12; WBVE + AT_CG, n = 18). The participants filled out the WHOQOL-bref Questionnaire before the first and after the last sessions. Statistical differences in the various domains of the WHOQOL-bref were not found. In conclusion, WBVE or AT alone or combined did not contribute in altering the quality of life of individuals exposed to these interventions

Acute Effects of Whole-Body Vibration Exercise on Pain Level, Functionality, and Rating of Exertion of Elderly Obese Knee Osteoarthritis Individuals: A Randomized Study

Introduction: Among chronic diseases, knee osteoarthritis (KOA) is a joint disease that causes important progressive alterations in the articular and periarticular structures, including synovial inflammation. Exercise has been suggested as an intervention to KOA individuals, and studies suggest that whole-body vibration (WBV) exercise decreases pain levels and favours the functionality of KOA individuals. Objective: The aim of the present study is to analyze the acute effects of WBV exercise on pain levels, functionality (Timed Up and Go (TUG test), anterior trunk flexion (ATF)), and rating of exertion of elderly obese KOA individuals. Methods: Thirty-seven individuals with KOA were allocated to a WBV exercise group (WBVEG), n = 19 (15 females/4 males), and a control group (CG), n = 18 (15 females/3 males). WBVEG performed one session of WBV exercise (11 min, using 5 Hz, 2.5, 5.0, and 7.5 mm, 0.12, 0.25, and 0.37 g). Three bouts were performed (working time of 3 min and rest time of 1 min) using a side-alternating vibrating platform (VP). The same position was used in CG; however, the VP was turned off and there was equipment coupled to the VP that emitted a sound like the vibrations. The pain level was evaluated using a visual analog scale (VAS). Functionality was evaluated with a TUG test and ATF. The rating of subjectively perceived exertion was measured with the category ratio CR-10 (BORG Scale CR-10), Results: A reduction of pain levels in WBVEG after the intervention (p = 0.001) and intergroups (p = 0.041) was found. A decrease of TUG test time in both groups (p = 0.001) and intergroups (p = 0.045) was found, while no statistical changes were observed in the Borg Scale score. Significant improvements of flexibility in both groups (p = 0.001) and intergroups (p = 0.043) were found. Conclusion: One session of WBV exercise can lead to important improvements in individuals with KOA, possibly triggered by physiological responses. However, more studies are needed, in this clinical context, to confirm these results

Sinergismo entre o vasto lateral e vasto medial oblíquo durante a marcha após a reconstrução do ligamento cruzado anterior

Objetivo: O objetivo deste estudo foi comparar a co-contração muscular (CCM) e ativação dos músculos vasto lateral (VL) vasto medial oblíquo (VMB) durante a marcha e uma amostra saudável – grupo controle (GC) e pacientes submetidos a reconstrução do ligamento cruzado anterior (RLCA). Métodos: Vinte e três indivíduos participaram neste estudo, 14 GC e 9 RLCA. A atividade mioelétrica do VL e VMO foram captados para cálculo da CCM. A razão VL/VMO foi obtida dividindo o sinal normalizado desses dois músculos em cada ponto da curva. O valor da CCM e a relação de ativação na fase de apoio duplo, fase de apoio simples, fase de apoio terminal e fase de balanço foram obtidas pelo cálculo da média aritmética dos valores de intensidade da curva comum em cada intervalo. Resultado: CCM foi significativamente menor no grupo RLCA durante a fase de apoio dupla (p=0.001), efeito máximo (1.72). Não foram encontradas diferenças entre as outras comparações. Conclusão: O resultado desse estudo mostrou que a contração dos músculos VL e o VMO na fase inicial de apoio duplo da marcha foi diferente entre indivíduos saudáveis e submetidos a RLCA. Este achado pode estar relacionado a diminuição da estabilidade patelofemoral durante a resposta a carga, aumentando o potencial risco de desenvolver lesões nesta articulação.Objective: The aim of this study was to compare vastus lateralis and vastus medialis oblique (VL/VMO) muscle co-contraction (MCC) and activation ratio during gait between healthy subjects- control group (CG), and those with anterior cruciate ligament reconstruction (ACLR). Methods: Twenty-three subjects participated in this study, 14 CG and 9 ACLR. The myoelectric activities of the VL and VMO were captured to calculate the MCC. The VL/VMO ratio was obtained by dividing the normalized signals of these two muscles at each point of the curve. The MCC values and the activation ratio in the initial double limb stance, single limb stance, terminal double limb stance and swing were obtained by calculating the arithmetic mean of the intensity values ​​of the common curve in each interval. Results: MCC was significantly lower in the ACLR group during the initial double limb stance phase (p=0.001), with a high effect size (1.72). No significant differences were found for the other comparisons. Conclusions: The results of this study showed that the VL and VMO muscles co-contraction in the initial double limb stance phase of gait was different between the healthy and ACLR individuals. This finding may be related to lower patellofemoral stability during the loading response, increasing the potential risk for the development of injuries in this joint

Efeitos da sinvastatina na hipertrofia lipídica da medula óssea induzida pelo uso de corticóides em ratos Effects of simvastatin in steroid-induced bone marrow lipidic hypertrophy in rats

OBJETIVOS: Avaliar o efeito do uso da sinvastatina (SV) sobre a área da medula ocupada por adipócitos (AMOA) na cabeça femoral de ratos com hipertrofia lipídica induzida pelo uso de hidrocortisona (HC). MÉTODOS: Foram utilizados 40 ratos (Rattus norvegicus albinus), machos, da linhagem Wistar, distribuídos em cinco grupos, cada um contendo oito animais, de acordo com a medicação administrada diariamente por 14 dias: HC (25mg), HC (25mg) + SV, HC (1mg), HC (1mg) + SV e soro fisiológico (SF). Foram realizadas dosagens séricas de triglicerídeos (TRI), colesterol total (COL), aspartato aminotransferase (AST) e alanina aminotransferase (ALT), antes e depois do tratamento. A AMOA da cabeça femoral foi determinada por morfometria. RESULTADOS: Os grupos foram semelhantes no início do experimento, com relação aos valores séricos de TRI, COL, AST e ALT. Os animais em que foi administrado HC apresentaram maior AMOA, quando comparados com os que receberam SF (p OBJECTIVES: To evaluate the effects of using simvastatin (SV) on the medullary area occupied by adipocytes (MAOA) in the femoral head of rats with lipidic hypertrophy induced by hydrocortisone (HC). METHODS: 40 male Wistar rats (Rattus norvegicus albinos) were distributed into five groups, each group with eight animals, according to the medication given daily during 15 days: HC (25 mg), HC (25 mg) + SB, HC (1 mg), HC (1 mg) + SV, and saline solution (SF). Serum triglyceride (TRI), total cholesterol (COL), aspartate aminotransferase (AST), and alanine aminotransferase (ALT) tests were performed before and after treatment. Femoral head MAOA was determined by morphometry. RESULTS: the groups had similar results of serum values of TRI, COL, AST, and ALT in the beginning of the experiment. The animals that received HC had greater MAOA when compared to those receiving SF (p < 0.0001), with statistically significant increases in the serum TRI and COL readings. MAOA was greater in the groups receiving HC than in the groups receiving JC + SV (p < 0.0001). In the group that received HC (1 mg) + SV, there was no significant difference in MAOA, when compared to the group that received SF (p = 0.5047), nor in the serum values of TRI (p = 0.1907) and COL (p = 0.4480), after the treatment. In the animals that received HC (25 mg) + SV, there was a significant difference in MAOA, when compared to the group that received SF (p < 0.0001), and in the serum readings of TRI (p = 0.0044) and COL (p = 0.0025), after the treatment. All groups presented increased serum levels of AST and ALT. The use of HC was related to a larger area occupied by adipocytes in the medulla of the femoral head, which was directly proportional to the dose given. This effect was reduced with the use of simvastatin. CONCLUSION: The use of simvastatin to reduce the bone medulla lipidic content induced by HC was significant, and more consistent in the group treated with low HC doses