José Jamacy de Almeida Ferreira

Atividade eletromiográfica no agachamento nas posições de 40º, 60º e 90º de flexão do joelho

The aim of this study was to compare the electromyographic (EMG) activity of the femoris rectus, femoris biceps, tibialis anterior and soleus muscles in squatting, associating the trunk in erect position with two angles of knee flexion (40° and 60°) and the trunk at 45° flexion with three angles of knee flexion (40°, 60° and 90°). All associations were performed with and without additional load (10 kg). The sample was composed of 12 healthy individuals with mean age of 21.1 ± 2.5 years and weight of 62.8 ± 7.4 kg. The EMG of the cited muscles was isometrically registered in 10 squatting positions. For statistical analysis, Friedman Two-Way ANOVA and the Newman-Keuls Post-Hoc test were used. The results showed co-activation between the femoris rectus and femoris biceps muscles with the trunk in flexion and at 40° of knee flexion and between the femoris rectus and soleus muscles in the other positions considered (p < 0.05). It was also possible to observe co-activation between tibialis anterior and femoris biceps muscles with knee at 40° and 60° of flexion, with the trunk erect and in flexion and between the tibialis anterior and soleus muscles in the other positions (p < 0.05). Concerning isolated muscular activation, higher knee flexion in squatting was an important factor to greater muscles activation, except for the soleus. Trunk position and the additional load of 10 kg have influenced in the muscular activation of the femoris rectus at 60° of knee flexion, in which the erect trunk provided more activation. The femoris biceps presented greater activation when the knee was in 40° of flexion and the trunk flexioned. The co-activation between the femoris rectus and biceps with the trunk in flexion, and between the femoris rectus and soleus in the other positions, lead to new possibilities of exercises in rehabilitation.

Static postural balance in healthy individuals: Comparisons between three age groups

The aim of the study was to compare static postural balance of healthy individuals of three age groups in different conditions of support and vision. Seventy one individuals, divided into 3 groups, were analyzed: young group (YG: 22.2 ± 2.1 years), middle aged group (MAG: 50.7 ± 5.7 years) and older individuals group (EG: 66.8 ± 5.4 years). Their balance was tested on a force platform, under 3 support and 3 visual conditions. Measures included: total (TD), anterior-posterior (APD) and mediolateral displacement (MLD) of the center of pressure (CoP). ANOVA revealed significant differences for interactions between group X support conditions and group X visual conditions for the 3 variables (p<0.01), with greater displacements for the MAG and EG groups during single-leg stance with partial and occluded vision (p<0.05). Static postural balance decreased over time in healthy individuals, and conditions of support and visual negatively affected balance with the increment of age.

Efeitos da suplementação de creatina na força máxima e na amplitude do eletromiograma de mulheres fisicamente ativas

Creatine supplementation has shown to enhance muscular strength. However, there is not a consensus on this effect on maximal isometric strength neither on electromyogram (EMG) amplitude. Thus, the aim of this study was to analyze the creatine supplementation effects on maximal isometric strength and EMG amplitude in physically active women. 27 women (age 23.04 ± 1.82 years, body mass 58.37 ± 6.10kg, height 1.63±0.05m and body mass index 21.93 ± 2.02kg/m2) were randomly assigned in creatine (CrG) (n = 13) or placebo group (PLG) (n = 14). The CrG and PLG ingested 20g/day of creatine and 20g/day of maltodextrin during six days, respectively. The strength was measured before and after supplementation using a isometric dynamometer during a maximal isometric voluntary contraction (MIVC) of a unilateral knee extension (3 sets of 6s with 180s rest period), and the EMG was acquired from the vastus lateralis muscle and its amplitude quantified using the root mean square (RMS) values. Two-way ANOVA (2 groups x 2 moments) was used for parametric data and Wilcoxon test for non-parametric analysis (p < 0.05). After supplementation, CrG significantly enhanced strength, with increase of 7.85% (p = 0.002); 7.31% (p = 0.001) and 5.52% (p = 0.000) for the first, second and third trials, respectively. In CrG, the RMS values significantly increased on the third trial (p = 0.026). No changes were found in GPL. Results suggest that creatine supplementation enhance maximal isometric strength and EMG amplitude can be useful to identify these performance modifications.

Effects of different montages of transcranial direct current stimulation on the risk of falls and lower limb function after stroke

Abstract Background: Stroke is associated with high rates of falling and severe impairment of lower limb in patients who survive. Objective: The aim of this study was to analyze the effectiveness of different montages of transcranial direct current stimulation (tDCS) on reducing falls and on lower limb function after acute stroke. Methods: Sixty participants with acute stroke were randomly allocated into four groups with different electrode’s setups: anodal, cathodal, bilateral and sham tDCS. Each patient received 10 stimulation sessions (five consecutive days for two weeks). Four Square Step Test, Occurrence of Falling Index, Overall Stability Index, Falls Efficacy Scale – International, Berg Balance Scale, Six-minute walk test and Sit to Stand Test were measured at baseline, post-treatment, and at one- and three-month follow-up. Results: At baseline, no differences between the groups in terms of clinical and demographic characteristics were found. However, after treatment and during follow up, all the groups that received active stimulation showed greater reduction in the risk of falls and improved performance of the lower limb’s motor skills when compared to the sham group. No significant differences were found between the three types of active montages in relation to the risk of falling. In relation to lower limb function, bilateral stimulation provided a higher improvement when compared to anodal and cathodal tDCS. Conclusions: This is the first trial with different setups of tDCS on acute stroke patients. tDCS presents as an effective treatment strategy in reducing the risk of falls and improving lower limb function after a stroke. ClinicalTrials.gov (NCT 02422173).

Stroke Treatment Associated with Rehabilitation Therapy and Transcranial DC Stimulation (START-tDCS): a study protocol for a randomized controlled trial

BackgroundTraditional treatment for motor impairment after stroke includes medication and physical rehabilitation. The transcranial direct current stimulation associated with a standard physical therapy program may be an effective therapeutic alternative for these patients.MethodsThis study is a sham-controlled, double-blind, randomized clinical trial aiming to evaluate the efficacy of transcranial direct current stimulation in activities of daily living and motor function post subacute stroke. In total there will be 40 patients enrolled, diagnosed with subacute, ischemic, unilateral, non-recurring stroke. Participants will be randomized to two groups, one with active stimulation and the other with a placebo current. Patients and investigators will be blinded. Everyone will receive systematic physical therapy, based on constraint-induced movement therapy. The intervention will be applied for 10 consecutive days. Patients will undergo three functional assessments: at baseline, week 2, and week 4. Neuropsychological tests will be performed at baseline and week 4. Adverse effects will be computed at each session. On completion of the baseline measures, randomization will be conducted using random permuted blocks. The randomization will be concealed until group allocation.DiscussionThis study will investigate the combined effects of transcranial direct current stimulation and physical therapy on functional improvement after stroke. We tested whether the combination of these treatments is more effective than physical therapy alone when administered in the early stages after stroke.Trial registrationNCT02156635 - May 30, 2014. Randomization is ongoing (40 participants randomized as of the end of December 2015).

CARACTERIZAÇÃO DAS FRATURAS DO FÊMUR EM PACIENTES DE UM HOSPITAL DE EMERGÊNCIA E TRAUMA EM JOÃO PESSOA-PB NO PERÍODO DE 2008/2009

Objetivo: Estudar a caracterizacao das fraturas do femur tratadas no Hospital de Emergencia e Trauma Senador Humberto Lucena, na cidade de Joao Pessoa-PB, entre os anos de 2008 e 2009. Material e Metodos: Trata-se de pesquisa descritiva e documental realizada a partir de uma amostra de 300 prontuarios de pacientes com diagnostico de fratura do femur. Utilizou-se um questionario composto por 20 variaveis objetivas sobre dados sociodemograficos, dados clinicos, informacoes hospitalares e intervencoes. Os dados foram analisados por meio do software Statiscal Package for the Social Sciences (SPSS) versao 16.0 para Windows, aplicando-se o teste qui-quadrado (x2) e adotando nivel de significância 0,05. Resultados: Observou-se que as fraturas com localizacao proximal do femur prevaleceram em mulheres idosas (>60 anos) e tiveram como causa a queda da propria altura, enquanto que as fraturas diafisarias acometeram predominantemente homens adultos jovens com idade ate 30 anos em decorrencia de acidentes automobilisticos. A saida hospitalar por alta clinica ocorreu em 89,4% dos casos, enquanto o obito foi registrado em 6,3% dos pacientes. Complicacoes gerais da internacao foram observadas em 25% dos casos. Conclusao: Verificou-se que a caracterizacao dos pacientes analisados segue um padrao de diagnostico clinico e distribuicao etaria com predominância de fraturas proximais em idosas caidoras e diafisarias em homens jovens acometidos por trauma de alta energia. DESCRITORES: Femur. Morbidade. Mortalidade.

Skin temperature changes during muscular static stretching exercise

This study aimed to investigate the acute effects of stretching exercise on skin temperature, flexibility, passive muscle stiffness, and pain during hamstring stretching in healthy young subjects. Thirty-one participants (n=31) were randomly divided into 2 groups: an experimental group (EG, n=15), which was submitted to hamstring stretching exercise for 180 sec, and the control group (n=16), which was not exercised. Skin temperature (TsK) was collected in subjects’ posterior thigh using a thermographic camera at 7 time points with intervals of 30 sec each: T0 (rest), T30, T60, T90, T120, T150, and T180. In addition, the knee range of motion, passive stiffness and muscle soreness (visual analogue scale) were recorded during the stretching procedure at the same times. The EG presented a small but progressive increase in TsK (30.8°C±0.6°C to 31.1°C±0.6°C, P<0.01), with an increased range of motion (P<0.01) and muscle soreness levels (P<0.01) during the gradual hamstring stretching protocol. Additionally, there was an increment of passive stiffness (P<0.01) that was partially reversed toward the end of the stretching period. This research presents evidence that constant, passive and progressive stretching of the hamstrings progressively increased the local TsK by about 0.3°C after 180 sec of stretching. These findings may help to understand the effects of repeated stress on the muscle-tendon unit and the role of muscle stretching in warm-up protocols and rehabilitation.

The influence of the external ankle support on the dynamic balance in volleyball athletes

El proposito de este estudio fue evaluar el efecto de los apoyos externos de tobillo en la propiocepcion y el equilibrio dinamico en atletas de voleibol. Diecisiete jugadores de voleibol (18,94±2,49 anos; 65,45±9,49 kg, 1,71±0,05 m, IMC=22,0±2,67 kg/m²). El equilibrio dinamico fue evaluado por el Star Excursion Balance Test(SEBT). Comparacion de los modos de estabilizacion (Si Estabilizador/SE, Ortesis/ORT y Vendaje Funcional/VF) y las lineas de cuadricula SEBT, y inter-miembros se fuera realizado. Evaluacion del SEBT mostro una diferencia significativa entre los grupos (p< 0,01), SE x ORT, SE x BF y entre lineas (p < 0,01), ademas de la interaccion linea/miembro en el MD y MND (p < 0,01). Los medios de estabilizacion externa probados (ORT x BF) se comportaron de manera similar, lo que restringe el alcance de las extremidades inferiores en la ejecucion del SEBT en algunas de las direcciones probadas.

PROGRAMA DE EXERCÍCIOS EM GRUPO PREVENTIVO DE QUEDAS MELHORA FUNÇÃO CARDIOVASCULAR DE IDOSOS

Objective: To analyze the influence of a kinesiotherapeutic program for the prevention of falls on the cardiovascular function in the elderly. Materials and Methods: The sample consisted of 18 community-living elderly with a mean age of 73.5 ± 8.8 years (14 women; 4 men) who participated in an exercise program for flexibility, strength, balance and proprioception. We measured systolic (SBP) and diastolic (DBP) blood pressure, heart rate (HR) and double product (DP) before and after exercise. The coefficient of variation (CV) of the measures was used, as well as paired t test and Wilcoxon test for comparison between baseline and endpoint after exercise. Results: In 10 sessions, there was an average CV lower than 10% for SBP, DBP and HR. As an acute effect of exercise, there was a significant increase in SBP and DBP and a significant decrease in HR. Comparing the data of the 1st session of exercise to those of the 10th session, we observed that the values of the variables tended to be reduced (except the initial DBP), but with significance only for the final DP. There was a greater reduction in SBP, HR and DP over 20 sessions compared to 10 sessions. Conclusion: The program for the prevention of falls provided chronic effects that are beneficial to cardiovascular function in the elderly, which may also be indicated for the management of cardiovascular diseases. DESCRIPTORS: Aged. Exercises. Arterial Pressure. Heart Rate.

Equilíbrio postural estático em indivíduos saudáveis: Comparações entre três grupos etários

The aim of the study was to compare static postural balance of healthy individuals of three age groups in different conditions of support and vision. Seventy one individuals, divided into 3 groups, were analyzed: young group (YG: 22.2 ± 2.1 years), middle aged group (MAG: 50.7 ± 5.7 years) and older individuals group (EG: 66.8 ± 5.4 years). Their balance was tested on a force platform, under 3 support and 3 visual conditions. Measures included: total (TD), anterior-posterior (APD) and mediolateral displacement (MLD) of the center of pressure (CoP). ANOVA revealed significant differences for interactions between group X support conditions and group X visual conditions for the 3 variables (p<0.01), with greater displacements for the MAG and EG groups during single-leg stance with partial and occluded vision (p<0.05). Static postural balance decreased over time in healthy individuals, and conditions of support and visual negatively affected balance with the increment of age.