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Abstract(s)
A orientação postural relaciona-se com o controlo ativo dos segmentos corporais relativamente à gravidade, base de suporte e informação aferente,com base nas referências internas e externas. A sequência de sentado para de pé (SP)é considerada a tarefa funcional mais comum na vida diária. Desta,a fase da translação anterior é a mais exigente do ponto de vista da organização do controlo postural,na sua componente de orientação. Analisar as alterações na orientação do tronco e membros inferiores e no comportamento do CoP, associados à realização da sequência de SP, em indivíduos com lesão do SNC, face à realização de um programa de intervenção em fisioterapia. Estudo de série de quatro casos, de indivíduos com lesão do SNC, há pelo menos 6 meses, afetando o território predominantemente irrigado pela artéria cerebral média. Foi implementado um plano de intervenção durante 3 meses com 2 momentos de avaliação (M0 e M1). Em ambos os momentos, foi avaliada a fase de translação anterior da sequência de SP com recurso à análise cinemática, através do software Kinovea®, bem como o comportamento do CoP, através da plataforma de pressões Emed® –AT/2. A intervenção foi baseada num processo de raciocínio clínico individualizado, para a identificação de problemas a resolver, utilizando a facilitação do movimento, através do input sensorial e propriocetivo, com o objetivo de promover o controlo motor e a aprendizagem motora. Após a intervenção, todos os participantes apresentaram uma orientação dos segmentos do tronco compatível com uma organização para a função extensora. Estas modificações foram acompanhadas de uma alteração na orientação das escapulas sobre a grade costal e dos fémures em relação à linha média, compatíveis com maior estabilidade. Em relação ao comportamento do CoP todos os participantes apresentaram um aumento do deslocamento do CoP (exceto o participante B)e da sua velocidade (exceto o participante A), bem como uma maior extensão máxima. Discussão/Conclusão:Após a realização de um programa de intervenção em fisioterapia, os indivíduos apresentaram, de uma forma geral, uma orientação do tronco e dos membros inferiores compatíveis com uma organização para a função extensora, embora os achados relativos ao comportamento do CoP não suportem os achados da análise cinemática.Contudo, e apesar das limitações, este estudo permite a identificação de diferenças ocorridas caso a caso, podendo servir como orientação para a prática clínica individualizada em indivíduos com alterações do CP.
Introduction: Postural orientation is related to the active control of body segments regarding gravity, support base and afferent information, based on internal and external references.The sequence from sitto stand(STS) is considered the most common functional task in daily life.From this, the flexion momentum,is the most challengingfrom the point of view of the organization of postural control in its orientation component.Objective: To analyze changes in trunk and lower limb orientation and CoP behavior associated with the performance of the STSsequence in individuals with CNS injury, due toimplementation of a physical therapy intervention program.Methods: Serial study of four cases of individuals with CNS injury sinceat least 6 months, affecting the territory predominantly irrigated by the cerebral middleartery.An intervention plan was implemented for 3 months with 2 evaluation moments (M0 and M1).In both moments, the flexion momentumphase of the STSsequence was evaluated using kinematic analysis, using the Kinovea® software, as well as the CoP behavior, using the Emed® -AT / 2 pressure platform.The intervention was based on an individualized clinical reasoning process to identify problems to be solved using movement facilitation through sensory and proprioceptive input, with the aim of promoting motor control and motor learning. Results: After the intervention, all participants presented an orientationof the trunk segments compatible with an organization for the extension function. These changes were accompanied by a change in the orientation of the scapulae over the costal grid and femurs in relation to the midline, compatible with greater stability. Regarding the behavior of CoP all participants showed an increase in CoP displacement (except participant B) and its velocity (except participant A), as well as a greater maximum extent. Discussion / Conclusion: After conducting a physical therapy intervention program, subjects generally presented trunk and lower limb orientation consistent with an organization for the extensor function, although CoP behavior findings doesn’tsupportthe findings of kinematic analysis. However, despite the limitations, this study allows the identification of differences that occur on a case-by-case basis and may serve as guidance for individualized clinical practice in individuals with postural controlalterations.
Introduction: Postural orientation is related to the active control of body segments regarding gravity, support base and afferent information, based on internal and external references.The sequence from sitto stand(STS) is considered the most common functional task in daily life.From this, the flexion momentum,is the most challengingfrom the point of view of the organization of postural control in its orientation component.Objective: To analyze changes in trunk and lower limb orientation and CoP behavior associated with the performance of the STSsequence in individuals with CNS injury, due toimplementation of a physical therapy intervention program.Methods: Serial study of four cases of individuals with CNS injury sinceat least 6 months, affecting the territory predominantly irrigated by the cerebral middleartery.An intervention plan was implemented for 3 months with 2 evaluation moments (M0 and M1).In both moments, the flexion momentumphase of the STSsequence was evaluated using kinematic analysis, using the Kinovea® software, as well as the CoP behavior, using the Emed® -AT / 2 pressure platform.The intervention was based on an individualized clinical reasoning process to identify problems to be solved using movement facilitation through sensory and proprioceptive input, with the aim of promoting motor control and motor learning. Results: After the intervention, all participants presented an orientationof the trunk segments compatible with an organization for the extension function. These changes were accompanied by a change in the orientation of the scapulae over the costal grid and femurs in relation to the midline, compatible with greater stability. Regarding the behavior of CoP all participants showed an increase in CoP displacement (except participant B) and its velocity (except participant A), as well as a greater maximum extent. Discussion / Conclusion: After conducting a physical therapy intervention program, subjects generally presented trunk and lower limb orientation consistent with an organization for the extensor function, although CoP behavior findings doesn’tsupportthe findings of kinematic analysis. However, despite the limitations, this study allows the identification of differences that occur on a case-by-case basis and may serve as guidance for individualized clinical practice in individuals with postural controlalterations.
Description
Keywords
Orientação postural Sentado para de pé Intervenção em fisioterapia Controlo Postural Postural orientation Sit to stand Physiotherapy intervention Postural Control