Resumo: A lesão do ligamento cruzado anterior (LCA) do joelho acarreta alterações somatosensoriais em função da perda de informações provenientes dos mecanorreceptores presentes no LCA. Esses receptores constituem importante fonte de informação sensorial, afetando o desempenho de vários atos motores, dentre os quais o controle postural. O estudo objetivou analisar o controle postural de indivíduos com joelhos normais e com lesão unilateral do LCA. Participaram 15 voluntários com lesão do LCA (grupo lesado) e 15 voluntários com joelhos normais (grupo controle). O controle postural foi analisado por plataforma de força, sendo o voluntário instruído a assumir a situação experimental em apoio unipodal direito e esquerdo, posicionado no centro da plataforma de modo estático e com os olhos fechados. A plataforma de força forneceu informações de forças e momentos no eixo vertical e horizontal, a partir das quais foi obtida a área de deslocamento do centro de pressão nas direções ântero-posterior e médio-lateral. Os resultados mostram que indivíduos com lesão do LCA apresentaram maior amplitude média de oscilação comparados aos do grupo controle, sugerindo que o deficit no controle postural seja devido à perda de informações proprioceptivas nos indivíduos com LCA. Esses resultados têm implicações para a abordagem clínica de indivíduos com lesão do LCA. Descritores: Biomecânica; Ligamento cruzado anterior; Postura; Propriocepção Abstract: Anterior cruciate ligament (ACL) injury leads to sensorimotor changes due to lack of information from mechanoreceptors at the ACL. These receptors are an important source of sensory information, affecting the performance of various motor responses, among which postural control. The purpose of this study was to assess postural control in individuals with normal knees and with unilateral ACL injury. Fifteen subjects with ACL injury and 15 healthy young subjects (control group) were submitted to postural control assessment by standing in single-leg stance (both right and left) on a force platform; they stood at the centre of the platform, with eyes closed, remaining in the position for 30 seconds. The force platform provided information on forces and moments along both vertical and horizontal axes, from which was obtained the centre of pressure displacement in anterior-posterior and medial-lateral directions. Individuals with ACL injury showed greater mean sway amplitude than healthy control ones, suggesting that their deficit in postural control might be due to lack of proprioceptive information. These results have implications for the clinical approach of individuals with ACL injury.

RESuMoIntrodução: As qualidades físicas precisam ser analisadas e estão associadas como fatores de risco a desenvolver lesões musculoesqueléticas durante o treinamento esportivo militar. Objetivo: Levantar a epidemiologia das lesões musculoesqueléticas ocorridas em tornozelo e pé de policiais militares. Materiais e Métodos: Foram coletados todos os prontuários de policiais militares que sofreram lesões prévias no tornozelo e pé durante o período de setembro de 2005 a agosto de 2011, as informações foram obtidas através da ficha de avaliação fisioterapêutica constatada nos prontuários, posteriormente os dados obtidos foram tabulados e analisados. Resultados: Após a coleta de dados dos prontuários foi observado que houve 29% de lesões ósseas, 32% de ligamentares e 35% de musculares. Conclusão: A entorse de tornozelo demonstra um risco à saúde pública como descrita pela classificação estatística internacional de doenças e problemas relacionados à saúde, sendo no meio militar também descrita como um risco durante a prática esportiva. Palavras

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Introduction: A decrease in postural control and proprioception is a common result of lower limb amputation. However, postural control adaptation in Paralympic sitting volleyball players with lower limb amputation is not yet understood. Objective: The purpose of this cross-sectional controlled study was to investigate static and dynamic postural control in sitting volleyball players with unilateral transfemoral amputation. Methods: Sixteen subjects participated in the study, eight of whom were amputees with unilateral transfemoral amputation (amputee group: age: 33.5 ± 5.6 years, weight: 77.7 ± 5.3 kg, height: 179.4 ± 5.3 cm) and eight physically active non-amputees (control group age: 27.2 ± 8.4 years, weight: 82.7 ± 6.6 kg, height: 178.7 ± 6.1 cm). Static and dynamic postural control was evaluated using the Neurocom® Balance Master System platform (Modified Clinical Test of Sensory Interaction on Balance, Limits of Stability, Rhythmic Weight Shift, Sit-to-Stand, Walk Across, and Step and Quick Turn). Statistical analyses were performed with the Shapiro-Wilk test, Levene's test, and Student's t-test for paired samples (p <0.05). Results: The amputee group demonstrated impaired postural control in all tests when compared to the control group (p <.05) for all postural tests except for the rhythmic change and sit-to-stand tests (p >.05). Conclusion: Despite training in sitting volleyball, our results demonstrated that amputees have poorer postural control in both static and dynamic tasks when compared to physically active non-amputees. Level of Evidence II; Prognostic Studies—Investigating the Effect of a Patient Characteristic on Disease Outcome / Retrospectivef Study.

It is estimated that 45-75% of chronic adult stroke patients have difficulty in using the hemiparetic upper limb (MS) in their daily life activities (DLAs). Functional scales are used in the practice of rehabilitation, in the search for diagnoses and prognoses, and in evaluating response to treatment. The Wolf Motor Function Test (WMFT) and Fugl-Meyer Assessment (FMA) scales are the instruments most commonly mentioned in the literature. Objective: The aim of this study was to review the use of the WMFT and FMA scales in the recovery of upper limb function in patients after chronic stroke. Method: We searched the MedLine database (PubMed) for articles published from 2000 to 2013. The PICO method was adopted as the search strategy. The descriptors used for the search were: (stroke OR cerebrovascular disorders OR intracranial arteriosclerosis OR thrombosis intracranial embolism) AND (Fugl-Meyer assessment OR wolf motor function test). Therapy/narrow was used as a search filter. Results: We found 181 studies, 89 of which were excluded because they did not meet the inclusion criteria or did not have a topic relevant to the review search. After selection by title and by abstract, 92 articles were fully read. Of these articles, 47 were excluded because they did not fulfil the search objective. All in all, 45 articles were reviewed. FMA is the tool most used and it was found that 80% of the studies applied this scale to evaluate responses to the different therapies. In these studies, the intervention most used was the Constrained Induced Therapy (CIT) (25%), followed by Robotics Therapy (22.2%). Although the WMFT was initially developed to assess the effects of CIT, nowadays this scale is used, after the application of other techniques, to assess the functional recovery of patients with stroke sequelae. In our survey, 44.4% of the studies used WMFT; of these, 35% assessed the effects of CIT, 15% assessed robotic therapy for the upper limbs, and 65% for different therapies. Conclusion: For randomized controlled trials, the FMA scale was more used to assess functional recovery in the upper limbs of chronic stroke patients, even after application of robotics therapy. However, we found that it is not the most appropriate scale to assess the same outcomes after CIT use. WMFT is the scale most widely used for functional assessment after application of CIT; it is more sensitive than FMA for bilateral therapy, and is highly applicable in virtual reality therapy.