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CONTEXTUALIZACAO: Esta revisao abordara os principais mecanismos celulares envolvidos na reducao e aumento da sintese de mioproteinas comumente associadas as situacoes de atrofia e hipertrofia muscular, respectivamente. OBJETIVO: Analisaremos os efeitos da estimulacao eletrica (EE) e do exercicio de alongamento sobre as vias moleculares envolvidas na atrofia e hipertrofia muscular. Serao descritos os principais efeitos e os limites desses recursos no musculo esqueletico, particularmente sobre o musculo desnervado. DISCUSSAO: Recentemente, nossos estudos mostraram que a EE, aplicada de modo semelhante ao realizado na pratica clinica, e capaz de amenizar o aumento da expressao de genes envolvidos na atrofia muscular. Entretanto, a EE nao foi efetiva para deter a perda de massa muscular decorrente da desnervacao. Em relacao ao alongamento, seus mecanismos de acao sobre o musculo desnervado nao sao totalmente conhecidos, e os trabalhos nessa area sao escassos. Estudos do nosso laboratorio identificaram que o alongamento aumentou o remodelamento da matriz extracelular e diminuiu a expressao de genes relacionados a atrofia no musculo desnervado. Porem, tambem nao foi suficiente para impedir a atrofia muscular apos a desnervacao. CONCLUSOES: Apesar do uso da EE e do alongamento muscular na pratica clinica, com objetivo de minimizar a atrofia do musculo desnervado, ainda ha carencia de informacoes cientificas que justifiquem a eficacia desses recursos para prevenir a atrofia no musculo desnervado.

BACKGROUND: Conservative treatments have been proposed for people with shoulder impingement syndrome (SIS), such as strengthening of the rotator cuff and scapular muscles and stretching of the soft tissues of the shoulder. However, there is a lack of studies analyzing the effectiveness of eccentric training in the treatment of SIS. OBJECTIVES: To evaluate the effects of eccentric training for shoulder abductors on pain, function, and isokinetic performance during concentric and eccentric abduction of the shoulder in subjects with SIS. METHODS: Twenty subjects (7 females, 34.2 SD 10.2 years, 1.7 SD 0.1 m, 78.0 SD 16.3 kg) with unilateral SIS completed the study protocol. Bilateral isokinetic eccentric training at 60º/s for shoulder abductors was performed for six consecutive weeks, twice a week, on alternate days. For each training day, three sets of 10 repetitions were performed with a 3-minute rest period between the sets for each side. The range of motion trained was 60° (ranging from 80° to 20°). The Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire was used to evaluate functional status and symptoms of the upper limbs. Peak torque, total work and acceleration time were measured during concentric and eccentric abduction of the arm at 60º/s and 180º/s using an isokinetic dynamometer. RESULTS: DASH scores, peak torque, total work and acceleration time improved (p

BackgroundFurther clarification is needed with regard to the degree of atrophy in individual muscle groups and its possible relationship to joint torque deficit poststroke.ObjectiveThe purpose of this study was to investigate quadriceps and hamstring muscle volume and strength deficits of the knee extensors and flexors in people with chronic hemiparesis compared with a control group.DesignThis was a cross-sectional study.MethodsThirteen individuals with hemiparesis due to chronic stroke (hemiparetic group) and 13 individuals who were healthy (control group) participated in this study. Motor function, quadriceps and hamstring muscle volume, and maximal concentric and eccentric contractions of the knee extensors and flexors were assessed.ResultsOnly the quadriceps muscle of the paretic limb showed reduced muscle volume (24%) compared with the contralateral (nonparetic) limb. There were no differences in muscle volume between the hemiparetic and control groups. The peak torque of the paretic-limb knee extensors and flexors was reduced in both contraction modes and velocities compared with the nonparetic limb (36%–67%) and with the control group (49%–75%). The nonparetic limb also showed decreased extensor and flexor peak torque compared with the control group (17%–23%). Power showed similar deficits in strength (12%–78%). There were significant correlations between motor function and strength deficits (.54–.67).LimitationsMagnetic resonance imaging coil length did not allow measurement of the proximal region of the thigh.ConclusionsThere were different responses between quadriceps and hamstring muscle volumes in the paretic limb that had quadriceps muscle atrophy only. However, both paretic and nonparetic limbs showed knee extensor and flexor torque and power reduction.

Ramirez C, Russo TL, Sandoval MC, Dentillo AA, Couto MAS, Durigan JLQ, Salvini TF: Joint inflammation alters gene and protein expression and leads to atrophy in the tibialis anterior muscle in rats. Am J Phys Med Rehabil 2011;90:930Y939. Objective: The aim of this study was to evaluate the effect of tibiotarsal joint inflammation in rat tibialis anterior muscle through muscle fiber cross-sectional area (CSA) and gene expression (atrogin-1, muscle ring fingerY 1[ MuRF1], myogenic differentiation-1 [MyoD], p38 mitogen-activated protein kinase [p38MAPK], nuclear factor kappa BYdependent [NFJB], tumor necrosis factorYalpha [TNF->]). Design: Wistar rats were randomly divided into three periods (2, 7, and 15 days) and assigned into four groups within each experimental period: control, sham, inflammation, and immobilization. Real-time polymerase chain reaction, Western blot, immunofluorescence, and muscle fiber CSA analyses were performed. Results: At 2 days, the inflammation group increased atrogin-1, MuRF1, and myostatin and reduced MyoD expression. At 7 days, the inflammation group increased atrogin-1, MuRF1, NFJB, p38MAPK, MyoD, myostatin, and TNF-> expression and TNF-> protein and reduced muscle fiber CSA. At 15 days, gene and protein expression in the inflammation group returned to basal levels, and CSA values were similar to those in control and sham groups. The immobilization groups have a similar pattern in all experimental periods, with increased atrogin-1, MuRF1, NFJB, and TNF-> gene expression and reduced muscle fiber CSA. The sham group had increased myostatin and atrogin-1 expression at 2 days and increased MyoD and myostatin expression at 7 days.

OBJECTIVES: The purpose of this study was to investigate the contributions of functional and morphological factors in the recovery of the quadriceps muscle after anterior cruciate ligament (ACL) reconstruction. METHODS: Nine subjects (31.3±5.8 years) underwent eccentric exercise sessions twice a week for 12 weeks. Quadriceps muscle function was evaluated using an isokinetic dynamometer (isometric and eccentric peak torque) and electromyography (RMS). Morphological changes were measured using magnetic resonance imaging. RESULTS: The initial evaluation showed a significant deficit in knee extensor torque in the involved limb and significant muscle atrophy along the length of the quadriceps. EMG activity was lower in all tested situations. Eccentric training significantly increased isokinetic torque (from 199±51 to 240±63, p

BACKGROUND: It is well known that eccentric training increases muscle strength and promotes greater neural activation, and therefore has been used in the recovery of knee extensors. The hypothesis of this study was that there would be a strong correlation between knee extensor torque and functional tests. OBJECTIVES: To investigate the relationship between knee extensor peak torque and functional tests of agility (runs) and propulsion (hop for distance) after short-term isokinetic eccentric training. METHODS: Twenty healthy and active male undergraduate students (age 22.5±2.1 years; height 1.72±0.10 m; weight 67.8±9.5 kg; body mass index: 22.5±2.0 kg/m²), with no abnormalities or history of injury of the limbs, performed an isokinetic assessment of the knee extensors and flexors and also functional tests before and after isokinetic training, which consisted of 3 sets of 10 MVECs at 30º/s, with 3 minutes of rest between sets, twice a week for 6 weeks. RESULTS: The eccentric training increased the extensor peak torque (16, 27 and 17%; P

BACKGROUND: The effectiveness of high-voltage pulsed current (HVPC) treatments in humans as a means of controlling edema and post-traumatic pain has not yet been established. Objective: To analyze the effects of HVPC plus conventional treatment on lateral ankle sprains. METHODS: This was a randomized, controlled, double-blind clinical trial with three intervention groups: CG (control group with conventional treatment); HVPC(-) group (conventional treatment plus negative polarity HVPC); HVPC(+) group (conventional treatment plus positive polarity HVPC). Twenty-eight participants with lateral ankle sprain (2 to 96h post-trauma) were evaluated. Conventional treatment consisted of cryotherapy (20min) plus therapeutic exercises. Additionally, the HVPC(-) and HVPC(+) groups received 30min of electrical stimulation (submotor level; 120 pps). Pain, edema, range of motion (ROM) and gait were assessed before the first treatment session and after the last treatment session. RESULTS: At the final evaluation, there were no significant differences between groups. Nevertheless, the HVPC(-) group had greater values in all assessed parameters. The data analysis showed that the HVPC(-) group had greater reductions in volume and girth, and greater recovery of ROM and gait velocity. This group also reached the end of the treatment (1.7 weeks; range 1.2-2.2) faster than the HVPC(+) group and the CG (2.2 weeks; range 1.8-2.6). CONCLUSIONS: There were no differences between the study groups, but the results suggest that HVPC(-) can accelerate the initial phase of recovery from ankle sprain. CONTEXTUALIZAÇÃO: A eficácia da estimulação elétrica de alta voltagem (EEAV) em humanos, como uma forma de tratamento para controlar o edema e a dor pós-traumáticos, ainda não foi estabelecida. OBJETIVO: Analisar o efeito da adição da EEAV ao tratamento convencional do pós-entorse de tornozelo em humanos. MÉTODOS: Ensaio clínico controlado e aleatorizado, duplo cego com três grupos de intervenção: grupo controle (GC) com tratamento convencional; tratamento convencional EEAV(-) e polaridade negativa EEAV (-); tratamento convencional e EEAV polaridade positiva EEAV(+). Vinte e oito portadores de entorse lateral do tornozelo (2 a 96 horas pós-trauma) foram avaliados. O tratamento convencional consistiu em crioterapia (20 minutos) e exercício terapêutico. Adicionalmente, os grupos EEAV(-) e EEAV(+) receberam 30 minutos de estimulação elétrica (nível submotor, 120pps). As variáveis de dor, edema, amplitude de movimento (ADM) e marcha foram avaliadas antes da primeira sessão de tratamento e após a última sessão de tratamento. RESULTADOS: Na avaliação final, não houve diferenças significativas entre os três grupos. Porém, os indivíduos do grupo EEAV(-) demonstraram valores superiores em todos os parâmetros de avaliação. A análise dos dados mostrou que o EEAV(-) apresentou maior redução do volume e do perímetro, maior recuperação da ADM e da cadência da marcha. Esse grupo também alcançou o término de tratamento mais rápido (1,7 semanas [1,2-2,2]), comparado com o EEAV(+) e o GC (2,2 semanas [1,8-2,6]). CONCLUSÕES: Não houve diferença entre os grupos estudados, mas os resultados sugerem que a EEAV(-) pode contribuir para acelerar a recuperação do entorse de tornozelo em sua fase inicial.

BACKGROUND: Different cryotherapy modalities have distinct effects on sensory and motor nerve conduction parameters. However, it is unclear how these parameters change during the post-cooling period and how the exercise carried out in this period would influence the recovery of nerve conduction velocity (NCV). OBJECTIVES: To compare the effects of three cryotherapy modalities on post-cooling NCV and to analyze the effect of walking on the recovery of sensory and motor NCV. METHODS: Thirty six healthy young subjects were randomly allocated into three groups: ice massage (n=12), ice pack (n=12) and cold water immersion (n=12). The modalities were applied to the right leg. The subjects of each modality group were again randomized to perform a post-cooling activity: a) 30min rest, b) walking 15 min followed by 15 min rest. The NCV of sural (sensory) and posterior tibial (motor) nerves was evaluated. Initial (pre-cooling) and final (30 min post-cooling) NCV were compared using a paired t-test. The effects of the modalities and the post-cooling activities on NCV were evaluated by an analysis of covariance. The significance level was α=0.05. RESULTS: There was a significant difference between immersion and ice massage on final sensory NCV (p=0.009). Ice pack and ice massage showed similar effects (p>0.05). Walking accelerated the recovery of sensory and motor NCV, regardless of the modality previously applied (p0,05). A marcha acelerou a recuperação da VCN sensorial e motora, independente da modalidade previamente aplicada (p

Neuromuscular recovery after peripheral nerve lesion depends on the regeneration of severed axons that re-establish their functional connection with the denervated muscle. The aim of this study was to determine the effects of electrical stimulation (ES) on the neuromuscular recovery after nerve crush injury in rats. Electrical stimulation was carried out on the tibialis anterior (TA) muscle after sciatic nerve crush injury in a rat model. Six ES sessions were administered every other day starting from day 3 postinjury until the end of the experiment (day 14). The sciatic functional index was calculated. Muscle excitability, neural cell adhesion molecule (N-CAM) expression, and muscle fiber cross-sectional area (CSA) were accessed from TA muscle. Regenerated sciatic nerves were analyzed by light and confocal microscopy. Both treated (crush+ES) and untreated (crush) groups had their muscle weight and CSA decreased compared with the normal group (P < 0.05). Electrical stimulation accentuated muscle fiber atrophy more in the crush+ES than in the crush group (P < 0.05). N-CAM expression increased in both crush and crush+ES groups compared with the normal group (P < 0.05). Regenerated nerves revealed no difference between the crush and crush+ES groups. Nevertheless, functional recovery at day 14 post-injury was significantly lower in crush+ES group compared with the crush group. In addition, the crush+ES group had chronaxie values significantly higher on days 7 and 13 compared with the crush group, which indicates a decrease in muscle excitability in the crush+ES animals. The results of this study do not support a benefit of the tested protocol of ES during the period of motor nerve recovery following injury.

BackgroundIt is well known that reducing tissue temperature changes sensory and motor nerve conduction. However, few studies have compared the effect of different cold modalities on nerve conduction parameters.ObjectiveThe purpose of this study was to compare the effects of ice pack, ice massage, and cold water immersion on the conduction parameters of the sural (sensorial) and tibial motor nerves.DesignAn experimental study was conducted in which the participants were randomly assigned to 1 of 3 intervention groups (n=12 per group). Independent variables were cold modality and pre- and post-cooling measurement time. Dependent variables were skin temperature and nerve conduction parameters.MethodsThirty-six people who were healthy, with a mean (SD) age of 20.5 (1.9) years, participated in the study. Each group received 1 of the 3 cold modalities, applied to the right calf region for 15 minutes. Skin temperature and nerve conduction parameters were measured before and immediately after cooling.ResultsAll 3 modalities reduced skin temperature (mean=18.2°C). There also was a reduction in amplitude and an increase in latency and duration of the compound action potential. Ice massage, ice pack, and cold water immersion reduced sensory nerve conduction velocity (NCV) by 20.4, 16.7, and 22.6 m/s and motor NCV by 2.5, 2.1, and 8.3 m/s, respectively. Cold water immersion was the most effective modality in changing nerve conduction parameters.LimitationsThe cooling area of the ice massage and ice pack was smaller than that of the cold water immersion. The examiner was not blinded to the treatment group. The population included only participants who were healthy and young.ConclusionsAll 3 modalities were effective in reducing skin temperature and changing sensory conduction at a physiological level that is sufficient to induce a hypoalgesic effect. The results suggest that cold water immersion, as applied in this study, is the most indicated modality for inducing therapeutic effects associated with the reduction of motor nerve conduction.

Peak torque (PT), total work (TW) and acceleration time (AT) were measured during isokinetic concentric and eccentric abduction of the shoulder in subjects with subacromial impingement syndrome (SIS) and healthy subjects. The SIS group consisted of 27 subjects (33.48 +/- 9.94 years) with unilateral SIS and it was divided into two groups: (1) SIS with the dominant involved side, (2) SIS with the nondominant involved side. The control group consisted of 23 healthy subjects (32.26 +/- 9.04 years). PT, TW and AT were measured bilaterally at 60 and 180 degrees /s. No significant interactions were found between group and side (P0.05), as well as no significant main effects of group and side (P0.05) for all variables during concentric abduction of the shoulder at both tested speeds. During the eccentric contractions, lower TW (P0.05) was demonstrated by the nondominant uninvolved side of SIS group at 60 degrees /s, and by the uninvolved sides of the SIS groups at 180 degrees /s compared to the dominant side of the controls. At 180 degrees /s, the nondominant uninvolved side of the SIS group demonstrated slower AT (P0.05) compared to the dominant side of the control group, as well as the nondominant involved side of the SIS group compared to the nondominant side of the controls. The results showed no alterations in the measured parameters during concentric and eccentric phases of isokinetic abduction in subjects with SIS when compared to a control group. However, alterations may be observed in the contralateral side during the eccentric phase of abduction in subjects with unilateral conditions of SIS.

This study evaluated the effectiveness of a rehabilitation program performed during working hours on function and pain in workers with subacromial impingement syndrome. Fourteen male workers (31.93 +/- 5.86 years) in the school supply industry were assessed. The duration of their shoulder pain was 28.50 +/- 33.64 months, and their amount of time in this industry was 9.07 +/- 3.68 years. The Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire evaluated function of the upper limbs. The Mc Gill Pain Questionnaire quantified the pain by the number of words chosen and the pain rating index (PRI). Subjects completed an 8-week rehabilitation program, twice a week, consisting of cryotherapy, strengthening, and stretching exercises. Subjects' outcome data were collected pre- and post-intervention. The results showed that DASH scores improved (p

The reliability of medial plantar, sural, and superficial peroneal nerve conduction studies (NCS) has not been widely studied. These nerves are usually involved in distal sensory neuropathies and their serial study is relevant in the clinical setting. Purpose: To determine the inter- and intrarater reliability of superficial peroneal, sural, and medial plantar NCS in healthy participants. Methods: Two raters performed the bilateral NCS twice in 20 healthy participants (23.5 3.5 years). Reliability was analyzed by the Bland- Altman method and intraclass correlation coefficient (ICC). Variability was established by the coefficient of variation. Results: The Bland-Altman method showed a good level of intra- and interrater agreement for all nerves. The amplitude (rater 1) and latency of the medial plantar nerve and the amplitude of the sural nerve (rater 2) had an intrarater ICC of 0.75. Interrater analysis showed concordance levels between moderate and very low. The highest coefficients of variations were found for amplitude and the lowest for nerve conduction velocity. Conclusions: Although the Bland-Altman method confirmed a good intra- and interrater reliability of the studied nerves, ICC analyses showed mixed results. These statistical approaches are complementary, and each one has advantages and disadvantages that must be considered in their application and interpretation.

Background and objective: Non-invasive ventilation (NIV) might improve peripheral muscle function and exercise capacity in severely disabled patients. This study evaluated the physiological impact of NIV on isokinetic concentric strength and endurance of lower limb muscles in patients with severe COPD. Methods: This clinical trial tested COPD patients (n = 24) and healthy subjects (n = 18). Subjects underwent isokinetic dynamometry tests while given either bi-level positive airway pressure ventilation (BV) or sham ventilation (SV), in a randomized order with 30 min of rest prior to each intervention. The inspiratory level of BV was set up to 14 cm H2O and expiratory pressure up to 6 cm H2O. Peripheral oxygen saturation (SpO2), heart rate (HR), systolic (SBP) and diastolic blood pressure (DBP) at the peak of exercise were measured for each intervention. Results: Compared with controls, COPD patients had lower values of SpO2 and HR (P

We evaluated the effects of chronic allergic airway inflammation and of treadmill training (12 weeks) of low and moderate intensity on muscle fiber cross-sectional area and mRNA levels of atrogin-1 and MuRF1 in the mouse tibialis anterior muscle. Six 4-month-old male BALB/c mice (28.5 +/- 0.8 g) per group were examined: 1) control, non-sensitized and non-trained (C); 2) ovalbumin sensitized (OA, 20 microg per mouse); 3) non-sensitized and trained at 50% maximum speed _ low intensity (PT50%); 4) non-sensitized and trained at 75% maximum speed _ moderate intensity (PT75%); 5) OA-sensitized and trained at 50% (OA+PT50%), 6) OA-sensitized and trained at 75% (OA+PT75%). There was no difference in muscle fiber cross-sectional area among groups and no difference in atrogin-1 and MuRF1 expression between C and OA groups. All exercised groups showed significantly decreased expression of atrogin-1 compared to C (1.01 +/- 0.2-fold): PT50% = 0.71 +/- 0.12-fold; OA+PT50% = 0.74 +/- 0.03-fold; PT75% = 0.71 +/- 0.09-fold; OA+PT75% = 0.74 +/- 0.09-fold. Similarly significant results were obtained regarding MuRF1 gene expression compared to C (1.01 +/- 0.23-fold): PT50% = 0.53 +/- 0.20-fold; OA+PT50% = 0.55 +/- 0.11-fold; PT75% = 0.35 +/- 0.15-fold; OA+PT75% = 0.37 +/- 0.08-fold. A short period of OA did not induce skeletal muscle atrophy in the mouse tibialis anterior muscle and aerobic training at low and moderate intensity negatively regulates the atrophy pathway in skeletal muscle of healthy mice or mice with allergic lung inflammation.

Considering that short bouts of stretching, as recommended in rehabilitation and sports activities, induce skeletal muscle and connective tissue adaptation, the hypothesis of this study was that MMP-2 activity is regulated by muscle stretch. The level of MMP-2 activity was, thereby, assessed after stretching in rat soleus muscle. Animals received a single session of stretching (10 stretches lasting 1 min each with 30 s of rest in between) and were evaluated immediately and after 8, 24, 48, 72 and 168 h. To evaluate the effect of repetitive sessions of stretching, three groups of animals were evaluated - one group after 2 sessions, another after 3, and a third after 7. MMP-2 activity was evaluated by zymography and MMP-2 mRNA was assessed by real-time polymerase chain reaction. None of the groups presented MMP-9 activity. MMP-2 activity and mRNA expression did not change after either single or repetitive sessions of stretching. In conclusion, the results of this study indicate that MMP-2 is not involved in the muscle stretch-induced remodeling.

Matrix metalloproteinases (MMPs) are crucial to the development and maintenance of healthy tissue and are mainly involved in extracellular matrix (ECM) remodeling of skeletal muscle. This study evaluated the effects of chronic allergic airway inflammation (CAAI), induced by ovalbumin, and aerobic training in the MMPs activity in mouse diaphragm muscle. Thirty mice were divided into 6 groups: 1) control; 2) ovalbumin; 3) treadmill trained at 50% of maximum speed; 4) ovalbumin and trained at 50%; 5) trained at 75%; 6) ovalbumin and trained at 75%. CAAI did not alter MMPs activities in diaphragm muscle. Nevertheless, both treadmill aerobic trainings, associated with CAAI increased the MMP-2 and -1 activities. Furthermore, MMP-9 was not detected in any group. Together, these findings suggest an ECM remodeling in diaphragm muscle of asthmatic mice submitted to physical training. This result may be useful for a better understanding of functional significance of changes in the MMPs activity in response to physical training in asthma.

OBJECTIVE: To assess the effects of neuromuscular electrical stimulation (NMES) associated with an isokinetic training program in healthy young men and women. METHODS: Twenty participants (ten men, ten women; 21±1.5 years) underwent an isokinetic training program for knee extensors of both sides (three sets of ten concentric repetitions at 30°/s) twice a week for four weeks. One limb underwent only the isokinetic strength training (Ex) while the other underwent the same training but with NMES associated with each contraction (Ex+NMES). The current used for NMES was the Russian current (frequency of 2,500Hz, 50 bursts/s and pulse duration of 200µs). Isometric and isokinetic concentric extensor torque at 30°/s were evaluated. RESULTS: The groups increased their peak torque in both test procedures, with no difference between Ex and Ex+NMES. The angle of peak torque increased for the Ex limb, thus showing a change in the tension-length relationship of the muscle group tested, which did not occur for the Ex+NMES limb. There was also a decrease in acceleration time in both limbs, without any effects from NMES on this variable. CONCLUSIONS: These results showed that the association between NMES and isokinetic concentric voluntary strength training did not improve the strength gains and neuromuscular properties of voluntary strength training itself for healthy young participants of both genders. OBJETIVO: Verificar os efeitos da estimulação elétrica neuromuscular (EENM) associada a um programa de treinamento isocinético em homens e mulheres jovens e sadios. MÉTODOS: Vinte indivíduos (dez homens, dez mulheres, 21±1,5 anos) submeteram-se a um programa de treinamento isocinético de ambos os seus extensores de joelho (três séries de dez repetições concêntricas a 30°/s) duas vezes por semana por quatro semanas. Um membro foi submetido apenas ao treinamento de força isocinético (Ex) enquanto o outro foi submetido ao mesmo treinamento, mas com EENM associada a cada contração (Ex+EENM). A corrente utilizada para a EENM foi a corrente russa (frequência de 2.500Hz, 50 bursts/s, duração de pulso de 200µs). O protocolo de avaliação incluiu o torque extensor isométrico e isocinético concêntrico a 30°/s. RESULTADOS: Os grupos aumentaram seu pico de torque em ambas as modalidades testadas, sem diferença entre Ex e Ex+EENM. O ângulo do pico de torque aumentou para o membro Ex, mostrando uma alteração da relação comprimento-tensão do grupo muscular testado, o que não aconteceu com o membro Ex+EENM. Houve também uma diminuição no tempo de aceleração de ambos os membros, sem efeito da EENM sobre este parâmetro. CONCLUSÕES: Estes resultados mostraram que a associação entre a EENM e o treinamento voluntário isocinético concêntrico não melhorou os ganhos de força e de propriedades neuromusculares do próprio treinamento de força voluntário para sujeitos jovens e sadios de ambos os gêneros.

Electrical stimulation is a procedure used to treat denervated muscles. The number of electrical stimulation sessions varies across muscle rehabilitation protocols, from daily to certain days throughout the week. The purpose of this study was to evaluate how muscle and nerve respond to different intervals of electrical stimulation applied to denervated muscle.Denervation of rat gastrocnemius muscle was imposed via nerve crush, and electrical stimulation was applied to the muscle either daily (Monday through Friday) or on alternate days (Monday, Wednesday, and Friday). Four experimental groups were studied: denervated, denervated plus daily electrical stimulation, denervated plus alternate-day electrical stimulation, and control.On the 12th day after nerve crush, levels of MyoD, myostatin, and atrogin-1 gene expression, as well as muscle fiber and nerve morphometry, were evaluated. Expression levels of all three genes were higher in the denervated group when compared with control. Also, expression levels of MyoD and myostatin were higher in denervated plus alternate-day electrical stimulation and denervated plus daily electrical stimulation groups when compared with denervated. The denervated plus daily electrical stimulation group had lower atrogin-1 expression, lower density of intramuscular connective tissue, and better morphometric nerve characteristics when compared with the denervated and denervated plus alternate-day electrical stimulation.These results indicate that the responses of both muscle and nerve to electrical stimulation after muscle denervation depend on the intervals of electrical stimulation application.

OBJETIVO: Avaliar a amplitude de movimento (ADM) e o torque flexor e extensor do joelho apos a realizacao de um programa de alongamento ativo excentrico dos musculos flexores do joelho. MATERIAIS E METODOS: Trinta e quatro voluntarios (23 mulheres e 11 homens), 34,42±9,3 anos, realizaram um programa de alongamento ativo excentrico dos musculos flexores do joelho na postura em pe, que consistiu de sete repeticoes de um minuto com 30 segundos de descanso entre as repeticoes. O programa de alongamento foi realizado duas vezes por semana, durante quatro semanas. A ADM de extensao e o torque flexor e extensor do joelho foram avaliados no dinamometro isocinetico pre e pos-programa de alongamento. O torque foi avaliado nos modos isometrico e isocinetico concentrico e excentrico a 30°/s e 60°/s. RESULTADOS: Houve aumento na ADM de 53,7±13° para 30,1±16° (p=0,0001), no torque isometrico flexor de 89±32Nm para 93±33Nm (p=0,01) e extensor de 178±67Nm para 187±73Nm (p=0,006). O torque flexor concentrico e excentrico a 30°/s aumentou de 90±31Nm para 96±31Nm (p=0,001) e de 100±34Nm para 105±35Nm (p=0,01), respectivamente. O torque extensor concentrico a 60°/s aumentou de 144±51Nm para 151±58Nm (p=0,02) e o excentrico a 30°/s de 175±71Nm para 189±73Nm (p=0,01). CONCLUSOES: O programa de alongamento proposto foi efetivo para aumentar a flexibilidade dos musculos alongados e torque dos grupos musculares agonistas (alongados) e seus antagonistas.

This study aimed at evaluating the thermographic changes associated with localized exercise in young and elderly subjects. An exercise protocol using 1 kg load was applied during 3 min to the knee flexors of 14 elderly (67 +/- 5 years) and 15 young (23 +/- 2 years) healthy subjects. The posterior thigh's skin temperature of the exercised limb and contralateral limb were measured by infrared thermography on pre-exercise, immediately post-exercise, and during the 10-min period post-exercise. Difference (p0.01) between elderly and young subjects was observed on pre-exercise temperature. Although differences were not observed between pre-exercise and immediately post-exercise temperature in the exercised limb, thermographic profile displayed heat concentration in exercised areas for both groups. Temperature reduction was only observed for the young group on the 10-min post-exercise (p0.05) in the exercised limb (30.7 +/- 1.7 to 30.3 +/- 1.5 degrees C). In contrast, there was a temperature reduction post-exercise (p0.01) in the contralateral limb for both groups. These results present new evidences that elderly and young subjects display similar capacity of heat production; however, the elderly subjects presented a lower resting temperature and slower heat dissipation. This work contributes to improve the understanding about temperature changes in elderly subjects and may present implications to the sports and rehabilitation programs.

Background and Purpose: Treadmill training with harness support is a promising, task-oriented approach to restoring locomotor function in people with poststroke hemiparesis. Although the combined use of functional electrical stimulation (FES) and treadmill training with body-weight support (BWS) has been studied before, this combined intervention was compared with the Bobath approach as opposed to BWS alone. The purpose of this study was to evaluate the effects of the combined use of FES and treadmill training with BWS on walking functions and voluntary limb control in people with chronic hemiparesis. Subjects: Eight people who were ambulatory after chronic stroke were evaluated. Methods: An A1-B-A2 single-case study design was applied. Phases A1 and A2 included 3 weeks of gait training on a treadmill with BWS, and phase B included 3 weeks of treadmill training plus FES applied to the peroneal nerve. The Stroke Rehabilitation Assessment of Movement was used to assess motor recovery, and a videography analysis was used to assess gait parameters. Results: An improvement (from 54.9% to 71.0%) in motor function was found during phase B. The spatial and temporal variables cycle duration, stance duration, and cadence as well as cycle length symmetry showed improvements when phase B was compared with phases A1 and A2. Discussion and Conclusions: The combined use of FES and treadmill training with BWS led to an improvement in motor recovery and seemed to improve the gait pattern of subjects with hemiparesis, indicating the utility of this combination method during gait rehabilitation. In addition, this single-case series showed that this alternative method of gait training—treadmill training with BWS and FES—may decrease the number of people required to carry out the training.

The objective of the present study was to assess the effect of transcutaneous electrical diaphragmatic stimulation (TEDS) on different types of diaphragm muscle fibers. Male Wistar rats (8-12 weeks old) were divided into 2 experimental groups (N = 8 in each group): 1) control, 2) animals submitted to TEDS [frequency = 50 Hz; T(ON)/T(OFF) (contraction/relaxation time) = 2/2 s; pulse duration = 0.4 ms, intensity = 5 mA with a 1 mA increase every 3 min for 20 min] for 7 days. After completing this treatment period, the I, IIA, IIB, and IID diaphragm muscle fibers were identified using the mATPase technique. Statistical analysis consisted of the normality, homoscedasticity and t-tests (P < 0.05). There was a 19.6% (P < 0.05) reduction in the number of type I fibers and a 49.7% increase (P < 0.05) in type IID fibers in the TEDS group compared with the control group. An important result of the present study was that electrical stimulation with surface electrodes was efficient in altering the distribution of fibers in diaphragm muscle. This therapeutic resource could be used in the treatment of respiratory muscle alterations.

Objective: This study assessed physical function and pain in male and female workers with shoulder impingement syndrome using the Brazilian Portuguese versions of the Disabilities of the Arm, Shoulder and Hand (DASH) and McGill pain questionnaires. Methods: Twenty-seven assembly line workers (18 men and 9 women; mean age of 33.26 ± 6.49 years) in the school supply industry were evaluated. The duration of the shoulder impingement pain was 31.74 ± 32.92 months and the amount of time of the workers in this industry was 11.08 ± 6.41 years. The DASH questionnaire was used to evaluate functional status and symptoms of the upper limbs of the workers. Using the McGill Pain Questionnaire, the pain was quantified by the number of words chosen and by the pain rating index (PRI). Results: The women presented higher scores (P< 0.05) than the men for both DASH overall and DASH work scores. The women chose more words (17.00 ± 2.59) than the men (13.33 ± 3.16) and also presented the highest total PRI (P< 0.05). Conclusions: The results obtained in this group of Brazilian workers with shoulder impingement identify the most commonly used descriptors of shoulder pain. Further, this study shows that females are more likely than males to refer physical disability and pain. Also, the DASH and McGill pain questionnaires are important and helpful tools in the clinical evaluation of shoulder impingement syndrome.

This study evaluated two different stretching protocols employed during a period of hind-limb immobilization in terms of their effects on muscle morphology. Quantitative data regarding the soleus muscle were obtained based on the clinical hypothesis that a high frequency of this exercise would improve the recovery of muscle structure. Twenty-four male Wistar rats were divided into four groups (n = 6 each): the control group (C); the immobilized group, in which the left hind limb was immobilized in order to maintain the soleus muscle in a fully shortened position for 3 weeks (I); the ‘immobilized and stretched every 3 days’ group, in which the left hind limb was immobilized as in the immobilized group, but with the soleus muscle stretched every 3 days for 40 min (Ist3); and the ‘immobilized (as in the immobilized group) and stretched every 7 days’ group (ISt7). All soleus muscles were excised 21 days after the beginning of the experiment, and were processed for (1) haematoxylin and eosin and myosin ATPase to evaluate muscle morphology and cross-sectional area and the proportions of the different fibre types, and (2) ultrastructural analysis. The cross-sectional area was found to have decreased in all fibre types (I, II and C), mainly in ISt7, when compared with the C group and ISt3 group. The proportion of the different fibre types did not show statistical difference between groups. Light and electron microscopy examination revealed signs of cell degeneration that was more intense in the group immobilized and stretched three times a week. In conclusion, sessions of passive stretching applied to the soleus during immobilization induce muscle fibre injury, suggesting that this therapeutic tool should be applied carefully to disused muscles.

CONTEXTUALIZAÇÃO: O instrumento mais utilizado pelos terapeutas para mensuração da amplitude de movimento (ADM) articular é o goniômetro universal. No entanto, há carência de estudos que analisem a confiabilidade das medidas da ADM do joelho realizadas no dinamômetro isocinético. OBJETIVO: O objetivo deste estudo foi analisar a correlação entre as medidas de ADM na articulação do joelho, realizadas com o goniômetro universal e no dinamômetro isocinético. MÉTODO: Foram avaliados 38 voluntários saudáveis (27 mulheres, 11 homens), com idade de 36 ± 11 anos, com limitação mínima de 20° na ADM de extensão do joelho. No membro dominante de cada sujeito foram realizadas três mensurações da ADM do joelho com o goniômetro e três mensurações no dinamômetro. RESULTADOS: Os resultados deste estudo mostraram que há alto grau de correlação entre as medidas da ADM do joelho obtidas com o goniômetro universal e no dinamômetro isocinético (Coeficiente de Correlação de Pearson = 0,90). CONCLUSÃO: Com os procedimentos realizados, tanto o goniômetro universal como o dinamômetro isocinético podem ser utilizados para avaliação da ADM do joelho, pois ambos apresentam mensurações confiáveis. BACKGROUND: The instrument most often used by therapists for measuring joint range of motion (ROM) is the universal goniometer. However, there is a lack of studies analyzing the reliability of knee joint ROM measured by the isokinetic dynamometer. OBJECTIVE: The purpose of this study was to analyze the correlation between the knee joint ROM measurements made using a universal goniometer and an isokinetic dynamometer. METHOD: 38 healthy volunteers (27 women, 11 men) aged 36 ± 11 years were evaluated. All of them had a minimum knee extension ROM limitation of 20°. Three knee ROM measurements were made using the universal goniometer and another three using the isokinetic dynamometer, on each subject's dominant limb. RESULTS: The results showed a high degree of correlation between the knee ROM measurements made using the two instruments (Pearson correlation coefficient = 0.90). CONCLUSION: From the procedures performed, both the universal goniometer and the isokinetic dynamometer can be used to evaluate knee ROM, since they both present reliable measurements.

Knee kinematics after anterior cruciate ligament (ACL) reconstruction is of interest in studies evaluating the effect of training programs. Many studies have addressed knee flexion/extension but not valgus/varus movements. Considering that joint stability is a major concern in ACL reconstruction surgery, movements occurring in the frontal plane of the knee also deserve attention. Knee extensor torque was analyzed by an isokinetic dynamometer and the angular amplitudes and velocities of flexion/extension and valgus/varus movements were analyzed by goniometry during gait 9 months after ACL reconstruction. The analysis was repeated after 3 months of eccentric isokinetic training of the quadriceps in five patients. The gait pattern was also recorded for 10 healthy controls. The knee extensor torque and flexion/extension range of movement during gait increased significantly after training. However, an unexpectedly increased valgus, most pronounced during the swing phase, which may imply adverse effects on the knee, was also observed in the ACL reconstructed knee. The recorded valgus angles may however be overestimated due to crosstalk. Thus, the extent of the increased valgus, as well as the mechanisms involved and the functional and clinical implications, need clarification before eccentric training after ACL reconstruction can be generally recommended.

Gomes AR, Soares AG, Peviani S, Nascimento RB, Moriscot AS, Salvini TF. The effect of 30 minutes of passive stretch of the rat soleus muscle on the myogenic differentiation, myostatin, and atrogin-1 gene expressions. Objective To evaluate the effect of passive stretch, applied for 30 minutes to the rat soleus muscle, on the myogenic differentiation (myoD), myostatin, and atrogin-1 gene expressions. Design Case-controlled study. Setting University laboratory. Animals Fifty 12-week-old male Wistar rats. Interventions Six groups of animals were given a single stretch bout and were evaluated immediately and 8, 24, 48, 72, and 168 hours later. Another 3 groups were evaluated immediately after 2, 3, and 7 stretches. An intact control group was also analyzed. Main Outcome Measures The messenger ribonucleic acid (mRNA) levels of myoD, myostatin, and atrogin-1 were assessed by real-time polymerase chain reaction. Results Twenty-four hours after a single session of stretch only, the myoD mRNA levels had increased compared with the control group, whereas an increase in the atrogin-1 expression was observed after 2, 3, and 7 stretches. Conclusions A single session of passive stretch increased the myoD gene expression, a factor related to muscle growth. Interestingly, daily stretches increased the atrogin-1 gene expression, a gene primarily associated with muscle atrophy. The results indicated that gene expression was responsive to the number of stretch sessions.

The aim of the present study was to determine the effect of stretching applied every 3 days to the soleus muscle immobilized in the shortened position on muscle fiber morphology. Eighteen 16-week-old Wistar rats were used and divided into three groups of 6 animals each: a) the left soleus muscle was immobilized in the shortened position for 3 weeks; b) during immobilization, the soleus was stretched for 40 min every 3 days; c) the non-immobilized soleus was only stretched. Left and right soleus muscles were examined. One portion of the soleus was frozen for histology and muscle fiber area evaluation, while the other portion was used to identify the number and length of serial sarcomeres. Immobilized muscles (group A) showed a significant decrease in weight (44 +/- 6%), length (19 +/- 7%), serial sarcomere number (23 +/- 15%), and fiber area (37 +/- 31%) compared to the contralateral muscles (P0.05, paired Student t-test). The immobilized and stretched soleus (group B) showed a similar reduction but milder muscle fiber atrophy compared to the only immobilized group (22 +/- 40 vs 37 +/- 31%, respectively; P0.001, ANOVA test). Muscles submitted only to stretching (group C) significantly increased the length (5 +/- 2%), serial sarcomere number (4 +/- 4%), and fiber area (16 +/- 44%) compared to the contralateral muscles (P0.05, paired Student t-test). In conclusion, stretching applied every 3 days to immobilized muscles did not prevent the muscle shortening, but reduced muscle atrophy. Stretching sessions induced hypertrophic effects in the control muscles. These results support the use of muscle stretching in sports and rehabilitation.

We determined the effect of stretching applied once a week to the soleus muscle immobilized in the shortened position on muscle fiber morphology. Twenty-six male Wistar rats weighing 269 +/- 26 g were divided into three groups. Group I, the left soleus was immobilized in the shortened position for 3 weeks; group II, the soleus was immobilized in the shortened position and stretched once a week for 3 weeks; group III, the soleus was submitted only to stretching once a week for 3 weeks. The medial part of the soleus muscle was frozen for histology and muscle fiber area evaluation and the lateral part was used for the determination of number and length of serial sarcomeres. Soleus muscle submitted only to immobilization showed a reduction in weight (44 +/- 6%, P = 0.002), in serial sarcomere number (23 +/- 15%) and in cross-sectional area of the fibers (37 +/- 31%, P0.001) compared to the contralateral muscles. The muscle that was immobilized and stretched showed less muscle fiber atrophy than the muscles only immobilized (P0.05). Surprisingly, in the muscles submitted only to stretching, fiber area was decreased compared to the contralateral muscle (2548 +/- 659 vs 2961 +/- 806 microm(2), respectively, P0.05). In conclusion, stretching applied once a week for 40 min to the soleus muscle immobilized in the shortened position was not sufficient to prevent the reduction of muscle weight and of serial sarcomere number, but provided significant protection against muscle fiber atrophy. In contrast, stretching normal muscles once a week caused a reduction in muscle fiber area.

The present study evaluated functional changes of quadriceps muscle after injury induced by eccentric exercise. Maximal isometric torque of quadriceps and the surface electromyography (root mean square, RMS, and median frequency, MDF) of the vastus medialis oblique (VMO) and vastus lateralis (VL) muscles were examined before, immediately after and during the first 7 days after injury. Serum creatine kinase (CK) levels and magnetic resonance imaging (MRI) were used to identify muscle injury. The subject was used as her own control and percent refers to pre-injury data. Experiments were carried out with a sedentary 23-year-old female. Injury was induced by 4 bouts of 15 maximal isokinetic eccentric contractions (angular velocity of 5º/s; range of motion from 40º to 110º of knee flexion). The isometric torque of the quadriceps (knee at 90º flexion) decreased 52% immediately after eccentric exercise and recovered on the 5th day. The highest reduction of RMS occurred on the 2nd day after injury in both VL (63%) and VMO (66%) and only VL recovered to the pre-injury level on the 7th day. Immediately after injury, the MDF decreased by 5 and 3% (VMO and VL, respectively) and recovered one day later. Serum CK levels increased by 109% on the 2nd day and were still increased by 32% on the 7th day. MRI showed large areas of injury especially in the deep region of quadriceps. In conclusion, eccentric exercise decreased the isometric torque and electromyographic signals of quadriceps muscle, which were recovered in one week, despite the muscle regeneration signals.

Tibialis anterior (TA) muscles of rats were evaluated 3 h, 3 and 30 days after intramuscular injection of ACL hemorrhagic toxin I (ACLHT-I, 5 mg/kg), partially purified from the venom of Agkistrodon contortrix laticinctus . Contralateral muscles were injected with saline. Three hours after ACLHT-1 injection: presence of hemorrhagic areas and myonecrotic muscle fibers. Three days: injured muscles showed areas in regeneration, some regions with delay of regeneration and bundles of normal fibers. An increased TA muscle weight was found when compared with the contralateral (0.45±0.03 g versus 0.36±0.04 g, p =0.04). Thirty days: areas of regenerated muscle fibers presented splits and centralized nuclei. Some regions were replaced by connective tissue. All muscle fiber types were injured but only the incidence of type IIC increased (3.4±2.0% versus 0.2±0.2%, p =0.0005). Regenerated areas of muscles were exclusively composed by fiber types II and IIC. Regenerated muscles decreased the muscle weight (0.49±0.1 g versus 0.66±0.05 g, p =0.03). In conclusion, ACLHT-I: (a) caused hemorrhage and muscle fiber injury; (b) injured both fiber types I and II; (c) increased the incidence of fiber type IIC and; (d) some muscle regions were replaced by connective tissue.

The response of different types of skeletal muscle fibers to a snake venom PLA2 myotoxin was tested in vivo by injecting ACL myotoxin (ACLMT) into mice. Both the soleus (slow-twitch) and gastrocnemius (fast-twitch) were examined at different time periods (3 h, 3 and 21 d) after the injection. All animals received 5 mg/kg myotoxin into the subcutaneous lateral region of the right hind limb, near the Achilles tendon; contralateral muscles were used as controls. Cross-sections (10 microm) of frozen muscle tissue were cut from the medial region of the muscle. Alternate serial sections were stained either with toluidine blue or for acid phosphatase, myofibrillar ATPase activity after alkali (pH 10.3) or acid preincubation (pH 4.3), succinate dehydrogenase or acetylcholinesterase. Several stages of necrosis were observed 3 h after ACLMT injection, in both superficial and deep regions of both muscles. In these same regions 3 d after injection, clusters of regenerated muscle fibers were present, and some of them presented AChE activity. Twenty-one days after ACLMT injection the muscle fibers of soleus and gastrocnemius presented only chronic signs of damage such as split fibers and centralized nuclei. Using m-ATPase reactions it was possible to determine that both muscle fiber types I and II were injured in both muscles. The number of type IIC fibers was significantly increased, and the number of type II fibers significantly decreased in the gastrocnemius 21 d after ACLMT injection, suggesting a change in muscle fiber type from type II to type I, through type IIC. The increased number of type IIC fibers and the presence of AChE activity in clusters of regenerating fibers and split fibers indicate that injury by ACLMT produces axonal remodeling and muscle fiber type change.

We have recently observed increase in Type I fibres in mouse soleus--but not extensor digitorum longus--muscles as a result of repeated muscle damage induced by voluntary wheel running. The most likely mechanism underlying the changes in fibre type composition is a redistribution of motor units with axonal sprouting and formation of new synapses. To test this hypothesis we exercised mice on a motor-driven treadmill once (3 x 3 h with 30 min rest periods in between, 14 m min-1, slope 6 degrees) or repeatedly (8-10 times at intervals of 3-5 days) and quantified axonal sprouting after staining with zinc iodide-osmium. In the contralateral solei, muscle damage and fibre type changes were evaluated with standard histochemical techniques. Significant numbers of damaged muscle fibers were found 0-15 days after a single exercise as compared to unexercised control animals (range 0.0-0.3% of the fibres in sedentary, n = 5, vs 2.1-14.8% in exercised muscles, n = 10) and repeated damage occurred in repeatedly exercised animals. In muscles of sedentary animals 3.8 +/- 1.4% SD of the examined endplates (n = 880, 5 muscles) had nodal or terminal sprouts. The incidence of sprouting was significantly elevated 3-21 days after a single exercise (7.5 +/- 1.8%, n = 2855, 12 muscles, P less than 0.01 signed-rank test), and more so after repeated running (12.0 +/- 2.5%, n = 1505, 6 muscles, P less than 0.01). Fibre type distributions were not different from controls 3 weeks after a single running episode, but after the 6-7 weeks of repeated running a significant increase in undifferentiated fibres at the cost of Type II fibres was found (9.7 +/- 3.4% versus 1.0 +/- 0.5% in sedentary controls, P less than 0.05, t-test); undifferentiated fibres express both Type I and Type II myofibrillar ATPase and are considered as fibres in the process of changing their types. These observations strongly support the assumption that sprouting and formation of new synapses--followed by motor unit enlargement and redistribution--occur as a result of muscle damage.

The expression of the extracellular matrix molecule tenascin was studied by immunocytochemistry and Western blotting in soleus muscles of adult mice after nerve damage (denervation), muscle injury (induced by enforced running or freezing) and functional block of synaptic transmission (botulinum toxin). Enhanced expression of tenascin in the extracellular spaces around focally damaged muscle fibres was found already 10 h after onset of running on a motor-driven treadmill which causes muscle injury in soleus muscle. Tenascin expression reached a peak at 2-3 days post-exercise, after which it declined gradually and became undetectable by two weeks after injury. Similarly, cryo-damage of soleus muscles in situ led to upregulation of tenascin. Chronic muscle denervation after sciatic nerve transection caused a persistent (studied up to 31 days) expression of tenascin at denervated endplates and in intramuscular nerve branches but not in other tissue compartments. Local application of botulinum toxin Type A, which results in muscle inactivity but not in tissue degeneration, however, did not induce tenascin expression 12 h to 12 days post-injection. Expression of tenascin after denervation and muscle damage, but its absence after paralysis, were verified by SDS-PAGE and Western blot analysis. Independent of the type of injury (muscle, nerve or both) the known major isoforms of mouse tenascin, as judged by M(r) comparison, were re-expressed, with no preponderance of individual M(r) forms. These results show that tenascin expression in adult muscles is induced by both axon and muscle fibre damage but not by muscle inactivity. In contrast, NCAM, in accordance with previous observations, showed enhanced expression both as a result of inactivity and in association with tissue repair.

Made available in DSpace on 2013-08-28T14:08:47Z (GMT). No. of bitstreams: 1 WOS000294821500002.pdf: 1263397 bytes, checksum: 006e551a12929e55e644c902f582b8ae (MD5) Made available in DSpace on 2013-09-30T18:49:24Z (GMT). No. of bitstreams: 2 WOS000294821500002.pdf: 1263397 bytes, checksum: 006e551a12929e55e644c902f582b8ae (MD5) WOS000294821500002.pdf.txt: 38006 bytes, checksum: 2724d2395222ce954eabfdb93516f69b (MD5) Previous issue date: 2011-08-24 Submitted by Vitor Silverio Rodrigues (vitorsrodrigues@reitoria.unesp.br) on 2014-05-20T13:58:49Z No. of bitstreams: 2 WOS000294821500002.pdf: 1263397 bytes, checksum: 006e551a12929e55e644c902f582b8ae (MD5) WOS000294821500002.pdf.txt: 38006 bytes, checksum: 2724d2395222ce954eabfdb93516f69b (MD5) Made available in DSpace on 2014-05-20T13:58:49Z (GMT). No. of bitstreams: 2 WOS000294821500002.pdf: 1263397 bytes, checksum: 006e551a12929e55e644c902f582b8ae (MD5) WOS000294821500002.pdf.txt: 38006 bytes, checksum: 2724d2395222ce954eabfdb93516f69b (MD5) Previous issue date: 2011-08-24 Background: It is not yet established if the use of body weight support (BWS) systems for gait training is effective per se or if it is the combination of BWS and treadmill that improves the locomotion of individuals with gait impairment. This study investigated the effects of gait training on ground level with partial BWS in individuals with stroke during overground walking with no BWS.Methods: Twelve individuals with chronic stroke (53.17 +/- 7.52 years old) participated of a gait training program with BWS during overground walking, and were evaluated before and after the gait training period. In both evaluations, individuals were videotaped walking at a self-selected comfortable speed with no BWS. Measurements were obtained for mean walking speed, step length, stride length and speed, toe-clearance, durations of total double stance and single-limb support, and minimum and maximum foot, shank, thigh, and trunk segmental angles.Results: After gait training, individuals walked faster, with symmetrical steps, longer and faster strides, and increased toe-clearance. Also, they displayed increased rotation of foot, shank, thigh, and trunk segmental angles on both sides of the body. However, the duration of single-limb support remained asymmetrical between each side of the body after gait training.Conclusions: Gait training individuals with chronic stroke with BWS during overground walking improved walking in terms of temporal-spatial parameters and segmental angles. This training strategy might be adopted as a safe, specific and promising strategy for gait rehabilitation after stroke. Cruzeiro do Sul Univ, Inst Phys Activ & Sport Sci, Grad Program Human Movement Sci, BR-01506000 São Paulo, Brazil Univ Fed Sao Carlos, Dept Phys Therapy, BR-13656905 Sao Carlos, SP, Brazil São Paulo State Univ, Dept Phys Educ, BR-13506900 Rio Claro, SP, Brazil São Paulo State Univ, Dept Phys Educ, BR-13506900 Rio Claro, SP, Brazil

Background Body weight support (BWS) systems on treadmill have been proposed as a strategy for gait training of subjects with stroke. Considering that ground level is the most common locomotion surface and that there is little information about individuals with stroke walking with BWS on ground level, it is important to investigate the use of BWS on ground level in these individuals as a possible alternative strategy for gait training. Methods Thirteen individuals with chronic stroke (four women and nine men; mean age 54.46 years) were videotaped walking on ground level in three experimental conditions: with no harness, with harness bearing full body weight, and with harness bearing 30% of full body weight. Measurements were recorded for mean walking speed, cadence, stride length, stride speed, durations of initial and terminal double stance, single limb support, swing period, and range of motion of ankle, knee, and hip joints; and foot, shank, thigh, and trunk segments. Results The use of BWS system leads to changes in stride length and speed, but not in stance and swing period duration. Only the hip joint was influenced by the BWS system in the 30% BWS condition. Shank and thigh segments presented less range of motion in the 30% BWS condition than in the other conditions, and the trunk was held straighter in the 30% BWS condition than in the other conditions. Conclusion Individuals with stroke using BWS system on ground level walked slower and with shorter stride length than with no harness. BWS also led to reduction of hip, shank, and thigh range of motion. However, this system did not change walking temporal organization and body side asymmetry of individuals with stroke. On the other hand, the BWS system enabled individuals with chronic stroke to walk safely and without physical assistance. In interventions, the physical therapist can watch and correct gait pattern in patients' performance without the need to provide physical assistance.