Avaliação clínica e cinemática dos ajustes posturais compensatórios / Clinical and kinematics evaluation of compensatory postural adjustment
AUTOR(ES)
Gabriel Bueno Lahóz Moya
DATA DE PUBLICAÇÃO
2009
RESUMO
Postural control aims postural orientation and equilibrium in order an individual accomplishes a task in a stable way. Alterations of postural adjustment are related to musculoskeletal diseases and falls, supporting the importance of a complete posture evaluation in clinical practice, including static and dynamic components of posture. The aim of this study was (1) to present a protocol to clinical evaluation of compensatory postural adjustment, to verify (2) interexaminer and intraexaminer reliability of this protocol and (3) agreement between clinical and kinematics evaluation, analyze (4) if the displacement of body segments during compensatory postural adjustment is related to posture during quiet stance or at final moment of compensatory postural adjustment and (5) the relationship between body segments during quiet stance and postural adjustment. Twenty healthy young non-athletic female participants standing upon a moveable support surface underwent to standardized backward and forward postural perturbation. An initial and a final frame representing the stable moment of quiet stance and the end of the postural perturbation, respectively, were selected, in a way that postural adjustment has occurred between these frames. Four independent examiners have made a clinical evaluation of initial and final frames of each participant using the protocol proposed for compensatory postural adjustment clinic evaluation. Examiners have repeated this evaluation seven days after the first evaluation. Kinematics analyses have been done to verify the ankle angle, knee angle, pelvic antepulsion, pelvic anteversion and trunk position. Measures of body segments position at initial and final frame and displacement of body segments during compensatory postural adjustment were acquired. Interexaminer and intraexaminer reliability of the proposed protocol was analyzed and answers of clinical evaluation and kinematics measures of initial and final frames were compared. The relationship between body segments position at initial and final frames and displacement of body segments during compensatory postural adjustment, as well as the relationship between body segments position at initial and final frames, were observed. The protocol proposed for compensatory postural adjustment clinic evaluation showed good inter-examiner and intra-examiner reliability with good agreement between clinical and kinematics evaluation. Motion pattern during compensatory postural adjustment was not related to posture during quiet stance or at final moment of compensatory postural adjustment. There is a strong relationship between lower limb segments either during quiet stance or at final moment of compensatory postural adjustment. This relationship should be considered to better understanding of motion pattern during maintenance of balance and treatment of lower limb musculoskeletal diseases in clinical practice.
ASSUNTO(S)
postura posture fisioterapia (especialidade) musculoskeletal equilibrium physical therapy (specialty) avaliação biomechanics equilíbrio musculosquelético biomecânica evaluation
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