Geraldo Fabiano de Souza Moraes

muSCuloSKeletal diSorderS in profeSSional violiniStS and violiStS. SyStematiC revieW

Due to the high physical and psychological demands of their work, musicians have a high risk of developing a range of health problems. The main causes of musculoskeletal disorders seen in instrumentalists are overuse, nerve compression and focal dystonia. The aim of this paper is to identify the musculoskeletal disorders that most frequently affect professional violinists and violists. 50 articles were read, of which 24 were used. The PEDro scale was used to determine the quality of the articles. The definition of risk factors can help in the development of prevention programs. Playing a musical instrument involves a combination of actions, including rapid, repetitive and complicated movements of the hands and fingers. The chairs used offer no other option than to adapt to the demands of body posture. To achieve the necessary skills to become a musician of a high standard, many hours of training and perfection are required. The neck, shoulder and temporomandibular joints are the most commonly affected areas, due to prolonged flexion of the head and shoulder required to hold the violin. The elbow and fingers are also common sites of disorders. It is necessary to warn musicians of the initial symptoms, and how they can prevent the disorder from worsening. Level I Evidence (Centre for Evidence-Based Medicine, Oxford, UK).

Confiabilidade intra e interexaminadores e erro da medição no uso do goniômetro e inclinômetro digital

INTRODUCAO: A amplitude de movimento articular (ADM) e um importante componente avaliado durante o exame fisico; porem, para que essa mensuracao possa ser utilizada, e necessario que ela seja confiavel e que suas propriedades de medida sejam conhecidas. OBJETIVOS: Verificar a confiabilidade inter e intraexaminadores das medidas realizadas pelo goniometro e inclinometro na avaliacao da ADM de flexao e extensao de joelho e cotovelo, e determinar o erro padrao da medicao (EPM) dos instrumentos em questao. METODOS: Foi avaliada ADM de flexao e extensao de cotovelo e joelho, bilateralmente, de uma amostra de individuos jovens saudaveis do genero masculino, com faixa etaria entre 18 e 30 anos, utilizando um inclinometro digital e um goniometro universal. RESULTADOS: A confiabilidade interexaminador variou de pequena a muito alta para os dois instrumentos, apresentando CCI de 0,24 a 0,96 para as medidas feitas com o goniometro, e de 0,02 a 0,98 para o inclinometro. O unico movimento que obteve confiabilidade muito alta para ambos os aparelhos e examinadores foi a flexao de joelho. O EPM determinado por meio da goniometria e inclinometria variou entre 0,21 e 12,75 graus. CONCLUSAO: O inclinometro digital apresenta melhores indices de confiabilidade que o goniometro para as medidas de ADM. Apenas quatro medidas obtiveram CCI alto e EPM abaixo de dois graus, e, assim, foram consideradas apropriadas para serem utilizadas clinicamente, todas essas realizadas com o inclinometro.

Efeito do Uso do Estabilizador Active Ankle System® na Altura do Salto Vertical em Jogadores de Voleibol

INTRODUCAO E OBJETIVO: Na pratica do voleibol, as entorses de tornozelo representam 25 a 50% das lesoes agudas. Medidas preventivas, como estabilizadores dinâmicos de tornozelo (EDT), sao frequentemente utilizadas, porem, ha controversias se esse dispositivo pode ou nao interferir no desempenho esportivo. O objetivo deste estudo foi analisar o efeito do EDT Active Ankle System® (AAS) na altura do salto vertical em jogadoras de voleibol. METODOS: Selecionou-se uma amostra de conveniencia de 14 atletas entre 14 e 18 anos de idade, do genero feminino. Estas foram instruidas a saltar simulando o gesto esportivo do ataque e do bloqueio com e sem o EDT, sobre placas de contato conectadas a um computador portatil que, atraves de um programa, calculava a altura do salto vertical. Previamente, foi feito um estudo-piloto para determinacao do coeficiente de correlacao intraclasse para as quatro condicoes de teste (n = 4), no qual os valores encontrados foram: ataque com EDT, 0,95; ataque sem EDT, 0,76; bloqueio com EDT, 0,92; bloqueio sem EDT, 0,89. Os dados de altura de cada tipo de salto vertical nas condicoes com e sem EDT foram comparadas atraves de testes t de Student para amostras pareadas. RESULTADOS: Para um nivel de significância de α = 0,05, nao foi encontrada diferenca significativa entre os saltos do ataque com o EDT (0,41 + 0,073m) e sem o EDT (0,41 + 0,086m), p = 0,517. Tambem nao foi encontrada diferenca significativa para os saltos do bloqueio com o EDT (0,31 ± 0,048m) e sem o EDT (0,32 ± 0,050m), p = 0,06. CONCLUSAO: Os resultados do presente estudo apontam para nao interferencia do uso do EDT AAS no desempenho do salto vertical em atletas de voleibol.

Shoes influence in women posture.

One of the most prevalent aspects is women with complaints of discomfort in the lumbar region for the use of high heeled shoe. Authors described that there may be a relation between attitude and the present discomfort, often associated with muscular fatigue and increase the forces of reaction soil during the use of such footwear. The purpose of this study was to evaluate possible changes postural associated with the use of different types of shoes and barefoot. Fifteen sedentary women were subjected to a static evaluation posture with the use of the software SAPO. Analysis of variance (ANOVA) repeated measures was used to investigate differences between the shoes in all variables postural analyzed. The results showed no significant difference in static position with the types of shoes and barefoot. It was concluded that the shoes did not interfere in static position.

Muscular activity in different locomotion plans with the use of various shoes types and barefoot.

UNLABELLED The objective of this study was to evaluate the electromyographic activity of the muscles of the leg and spine associated with different types of shoes and barefoot, in the various plans of locomotion, in the situations before and after fatigue. METHODS Is a cross-sectional study, which was used a sample of convenience with 15 young women, aged between 18 and 35 years, sedentary. The examined muscles were tibialis anterior, gastrocnemius medialis and lateralis and erector spinae. The muscular activity was assessed during locomotion on flat surface, up and down stairs and in an inclined surface. The shoes were a high-heeled, small heeled, tennis, slipper and barefoot. RESULTS The results of electromyographic analysis showed that the muscles of the leg had greater electromyographic activity in the position of pre-fatigue of the lower limbs and erector spinae in the postfatigue of the lower limbs, in most of the conditions and situations. DISCUSSION Adaptive conditions associated with regular use of high shoes, has been widely questioned in relation to the incidence of injuries. CONCLUSION In post-fatigue of the lower limbs, there was a decline in the activities of the muscles of the leg and increased recruitment of the erector muscles justified by the need for greater stability of the spine and pelvis during the locomotion of young women.

Functional analysis of scapular position in assymptomatic professors

UNLABELLED The impaired performance of the muscles of the scapular region may result in injuries, fatigue, weakness and pain. The main objective of this research was to analyze the scapular positioning during the abduction of the shoulder movement in the frontal, scapular and sagittal plans. METHOD This cross-sectional study comprised a convenience sample of 20 individuals. It was used the disability of the arm, shoulder and hand questionnaire (DASH Brazil), the digital inclinometer was used for measuring the scapular positioning. Having the purpose of regulating and ensuring the correct positioning of the upper limbs Assessed in the plans, it was developed the bulkhead which was used while the examination was performed. RESULTS The population study was asymptomatic. No significant difference was found for the right shoulder during the concentric and eccentric contraction at all angles of scapular inclination on the three analyzed plans. Significant difference was found in the left shoulder during the concentric contraction in the scapular angle at 90° and in the eccentric contraction at the scapular angles of 30°, 60° and 90° of inclination in the frontal plan compared to men and women. Furthermore, it was found a decreasing left shoulder in the scapular angle during the eccentric contraction above 90° in the scapular and sagittal plans when compared to men and women. CONCLUSION we concluded that in the three plans studied, the scapula behaved differently various angles in the measured and yet it was influenced by the direction of motion. Moreover, it is possible to say that showed that this study there is a difference in the rotational behavior of the scapula relating to women and men due to the anthropometric existed differences between them.

Taking care of you and care for others: an analysis of the activity of the work of technical and nursing assistants of a psychiatric institution for children and adolescents.

Our objective in this study, the analysis of potential fields of risk management in nursing work in psychiatric care to adolescents and children, while settings that go from the relationship between technical and organizational determinants of work activity and the skills of operators. It was established focus on the work process of the Technical and Nursing Assistants to seek for response elements in an attempt to understand the health-disease process experienced by these workers. It was used for analysis and data collection, through the method of Ergonomic Work Analysis (EWA), fifteen workers of nursing staff - T&NA, between effectives and contractors, and the strategies of action and regulation of these workers in relation to the interface that they deal with. The results show that the workers are exposed to all charges in an intense and specific way, causing physical and mental wear, as it approaches the psychological distress, exposure to the psychic pressure, not only through contact with the object of work, but the complexity of these relationships that are involved in nursing staff.

Do prescrito ao real: a gestão individual e coletiva dos trabalhadores de enfermagem frente ao risco de acidente de trabalho

The objective of this study is to analyze the constraints faced by the nursing assistants and technicians in a pediatric clinic sponsored by a state foundation during their work activities and identify the strategies adopted by them in order to guarantee the achievement of their production goals and job satisfaction and ensure their protection against workplace accidents. The method of Ergonomic Work Analysis (EWA) was used for analysis and data collection of 59 tenured and temporary nursing workers with intermediate and technical level of education and to investigate the strategies related to actions and employment regulation concerning the interfaces they deal with. The results show that among the constraints assessed in this institution the most evident are: double shift, diversity of employment contracts (tenure and temporary), risks to which these professionals are exposed, and the lack of knowledge about their object of work. It can be said that these constraints increase physical, psychic, and cognitive workload. Aiming to reduce such workloads, the workers try to develop strategies from their own experience, expertise, and values in order to deal with the risks in the workplace.

Avaliação da atividade eletromiográfica com ou sem o uso de diversos tipos de calçado, em diferentes planos de locomoção

INTRODUCTION: It is very common womens complaints of discomfort in the lumbar region, caused by the use of high heeled shoes. OBJECTIVE: The objective of this study was to evaluate the electromyographyc activity of the muscles of the leg and spine associated with different types of shoes and barefoot, in various plans of locomotion, before and after fatigue. MATERIALS AND METHODS: This is a cross-sectional study, in which was used a sample of convenience with 15 young women, aged between 18 and 35 years, sedentary. The examined muscles were tibialis anterior, gastrocnemius medialis and lateralis and erector spinae. The muscular activity was assessed during locomotion on flat surface, up and down stairs and in an inclined surface. The shoes were high-heeled, small heeled, snickers, slipper, and it was also made an evaluation in barefoot. RESULTS: The results of electromyographyc analysis showed that the muscles of the leg had greater electromyographyc activity in the position of pre-fatigue of the lower limbs and erector spinae in the post-fatigue of the lower limbs, in most of the conditions and situations. CONCLUSION: Adaptive conditions associated with regular use of high heels has been widely questioned in relation to the incidence of injuries. In post-fatigue of the lower limbs, there was a decline in the activities of the muscles of the leg and increased recruitment of the erector muscles, justified by the need for greater stability of the spine and pelvis during the locomotion of young women.