Daniel Neves Rocha

Multidirectional Pelvic Floor Muscle Strength Measurement

Pelvic floor muscle (PFM) strength measurement provides useful information for the study of pelvic floor dysfunctions. Vaginal digital palpation, intravaginal pressure measurements, and the use of a dynamometric speculum represent currently available clinical methods for evaluating PFM strength. However, none of these methods provide a dynamic measurement of pelvic floor strength in multiple directions simultaneously. The aim of the present paper is to report the development and first measurement trial of a device that follows the vaginal canal morphology and is able to measure pelvic floor strength multidirectionally.

Effects of Intensive Arm Training With an Electromechanical Orthosis in Chronic Stroke Patients: A Preliminary Study

OBJECTIVES To evaluate the use of an electromechanical device, comprising an exoskeleton, a static orthosis, and a glove, for functional rehabilitation of the elbow and hand in patients with hemiparesis, and to compare it with physical therapy rehabilitation. DESIGN Pretest-posttest design. SETTING Rehabilitation laboratory. PARTICIPANTS Volunteer sample of persons (N=12) with persistent hemiparesis from a single, unilateral stroke within the past 3 to 36 months. INTERVENTIONS The volunteers were randomly divided into 2 groups. One group was treated with a conventional program of physiotherapy, and another group participated in a training program in which an electromechanical orthosis was used. All volunteers received 24 sessions, held 3 times a week for 8 weeks. MAIN OUTCOME MEASURES Modified Ashworth Scale (MAS), Fugl-Meyer Assessment (FMA), and electromyogram (EMG) amplitude. RESULTS No statistical difference was found in the initial and final values of the MAS. Both groups showed a significant increase for the total scores of the FMA. However, only the group treated with the orthosis showed an increase in FMA scores related to the wrist and hand joint. The EMG analysis showed increased EMG amplitudes for all muscles in the group treated with the orthosis, whereas the group treated with physiotherapy showed gains in electromyographic activity only in the extensor digitorum communis. Intergroup comparison showed that the initial FMA scores of the wrist/hand were higher in the group treated with physiotherapy. However, after training, the scores in the group that used the orthosis were equivalent to those of the physiotherapy group. CONCLUSIONS The results suggest that this device can be an auxiliary tool to help the conventional rehabilitation program of motor function of the affected upper extremity.

Determination of expander apparatus displacements and contact pressures on the mucosa using FEM modelling considering mandibular asymmetries

This paper presents a method for prediction of forces and displacements in the expansion screw of a modified mandibular Schwarz appliance and the contact pressure distributions on the mucosa during malocclusions treatment. A 3D finite element biomechanical model of the complete mandible–mucosa–apparatus set was built using computerised tomographic images of a patients mandible and constructive solid geometry by computer software. An iterative procedure was developed to handle a boundary condition that takes into account the mandibular asymmetries. The results showed asymmetries in the contact pressure distributions that indicated with precision the patients malocclusion diagnosis. In vivo measurements of contact pressure using piezoelectric sensors agreed with the computational results. It was shown that the left and right ends of the expansion screw move differently with respect to the patient mandible, even though the expansion screw has an opening mechanism to ensure equal stretching at both ends. The contact pressures between the apparatus and the mucosa vary linearly with applied forces, which can simplify the analysis of the biomechanical behaviour of the expander mandible apparatus. The biomechanical modelling proposed in this paper can be a useful tool to improve malocclusions treatment, safely avoiding the use of forces acting on live structures beyond the biological tolerance, which could result in traumatic effects.

3D biomechanical model of the human hand using FEM

The human hand is responsible for a significant part of daily activities, becoming one of the most important tools of the human body. Hand injuries caused by different pathologies, by trauma or by the use of manual instruments with low ergonomics are pointed as the cause of social problems affecting individuals with limited capacity of using their hands. Designs of more ergonomic instruments are an important step to obtain comfortable and useful instruments to prevent hand injuries. Information about the pressure in the palm of the hand and the acting forces in the tendons of the fingers and wrist are useful to study. The discomfort, pain, muscle-skeletal and tendon injuries are consequences of using non-ergonomic instruments. The utilization of 3D models of the human hand has become a valuable tool, aiding the studies for the design of artificial members with more accurate controls and design of ergonomic instruments. The aim of this work is to create a 3D finite element model of the human hand, characterize the constitutive tissues (bones, skin and ligaments) and perform the simulation of the index fingers flexion. The devised numerical model was successfully implemented leading to stable and easily converged results, showing that the 3D biomechanical model of human hand is robust.

“Ganhando o Brasil para Jesus”: alguns apontamentos sobre a influência do movimento fundamentalista norte-americano sobre as práticas políticas do pentecostalismo brasileiro("Winning Brazil for Jesus":some notes about the American fundamentalist movement)

Este artigo apresenta uma breve reflexao sobre a politizacao do fundamentalismo protestante norte-americano e sua possivel influencia no tipo de praxis sociopolitica que vem caracterizando o pentecostalismo brasileiro a partir de meados da decada de 1980. Partindo de uma discussao sobre o que seria, de fato, o fundamentalismo e sobre os desenvolvimentos e reconfiguracoes desse movimento ao longo da historia norte-americana, buscar-se-a analisar a influencia e os possiveis paralelos entre o fundamentalismo e o recente engajamento politico-eleitoral que vem marcando o pentecostalismo brasileiro. Observando-se a historia recente do pentecostalismo brasileiro, pode-se perceber, especialmente apos 1986 (ano em que as igrejas pentecostais se organizaram para eleger seus representantes na Assembleia Nacional Constituinte), tal influencia do modelo fundamentalista na utilizacao da midia, no conservadorismo politico, na formacao de grupos de pressao, na defesa dos valores da familia, nos projetos de eleicao de politicos comprometidos com os posicionamentos das igrejas, na busca do estreitamento das relacoes com o Estado na busca de influir em suas decisoes.