JULIA MARIA D ANDREA GREVE
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Ortopediae Traumatologia, Faculdade de Medicina - Docente
Instituto de Ortopedia e Traumatologia, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/41 - Laboratório de Investigação Médica do Sistema Músculoesquelético, Hospital das Clínicas, Faculdade de Medicina - Líder
Instituto de Ortopedia e Traumatologia, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/41 - Laboratório de Investigação Médica do Sistema Músculoesquelético, Hospital das Clínicas, Faculdade de Medicina - Líder
16 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 16
- RELATIONSHIP OF FORCE PLATFORM WITH THE CLINICAL BALANCE EVALUATION SYSTEMS TEST IN OLDER ADULTS(2020) ERNANDES, Rita De Cassia; BRECH, Guilherme Carlos; LUNA, Natalia Mariana Silva; NUNES, Michele Figueira; GREVE, Julia Maria D'Andrea; LEME, Luiz Eugenio Garcez; ALONSO, Angelica CastilhoThe aging process can alter the organization of postural control causing instability; literature shows several equipment and clinical tests whose purpose is to measure postural balance, involving different protocols and methodologies. Objective: To evaluate postural balance during the task to walk over the force platform (turn and return) and its relationship with clinic balance test (BESTest) in older adults. Methods: 60 older people of both sexes, aged 60 to 79 years, were tested in the force platform (NeuroCom Balance) and BESTest to evaluate postural balance. Results: negative correlations were found when comparing domains of the clinical test with stabilometric parameters in time and velocity variables of the tests Step/Quick turn. The highest correlations were in the total score (time spent to perform the task - 0.41, and in the velocity left side - 0.33/right side - 0.43), as well as in the stability limit (time spent to perform the task left side - 0.34/right side - 0.37, and the equilibrium velocity left side - 0.37/right side - 0.43). Conclusion: There are slim correlations between the clinical test and force platform variables, showing that each test measures different parameters.
- Association between handgrip strength, balance, and knee flexion/extension strength in older adults(2018) ALONSO, Angelica Castilho; RIBEIRO, Samia Maria; LUNA, Natalia Mariana Silva; PETERSON, Mark D.; BOCALINI, Danilo Sales; SERRA, Marcos Mauricio; BRECH, Guilherme Carlos; GREVE, Julia Maria D. Andrea; GARCEZ-LEME, Luiz EugenioThe objective of the study was to examine the association between handgrip strength (HGS), knee flexion and extension strength, and static and dynamic balance in older women. One hundred and ten women with a mean age of 67.4 +/- 5.9 years were assessed for dynamic postural balance using the Time Up & Go Test (TUG) with and without cognitive tasks. Semi-static balance was assessed by means of a force platform; knee flexor and extensor muscle strength was calculated using an isokinetic dynamometer; and HGS using a hand held dynamometer. Weaker HGS was significantly correlated with worse performance in dynamic postural balance, as well as performance with TUG with and without cognitive tasks; however, there was no correlation between HGS and static balance. There was a moderate positive correlation between knee flexion/extension strength and HGS. This suggests that HGS could be used as a proxy indicator of overall strength capacity for clinical screening among older women.
- Biomechanical evaluation in runners with Achilles tendinopathy(2021) ANDERE, Nathalie Ferrari Bechara; GODOY, Alexandre Leme; MOCHIZUKI, Luis; RODRIGUES, Marcelo Bordalo; FERNANDES, Tulio Diniz; SOARES-JUNIOR, Jose Maria; ALONSO, Angelica Castilho; LUNA, Natalia Mariana Silva; BRECH, Guilherme Carlos; GREVE, Julia Maria D'AndreaOBJECTIVES: To evaluate the clinical characteristics, ground reaction force (GRF), and function of the plantar muscles and dorsiflexors of the ankle in runners with and without Achilles tendinopathy (AT) and in non-runners. METHODS: Seventy-two participants (42 men, 30 women; mean age: 37.3 +/- 9.9 years) were enrolled in this cross-sectional study and divided into three groups: AT group (ATG, n=24), healthy runners' group (HRG, n=24), and non-runners' group (NRG, n=24). Both ankles were evaluated in each group. The American Orthopedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Scale was used for clinical and functional evaluation. GRF was evaluated using force plates and muscle strength was evaluated using an isokinetic dynamometer. RESULTS: The AOFAS scores were lower in the ATG. The strike impulse was higher in the ATG than in the HRG and NRG. However, GRF was similar among the groups. The ATG exhibited lower total work at 120 degrees/s speed than the HRG. The peak torque in concentric dorsiflexion was lower in the NRG than in the ATG and HRG. The peak torque and total work in concentric plantar flexion were lower in the NRG than in the ATG. The peak torque and total work in eccentric plantar flexion were lower in the NRG than in the ATG and HRG. CONCLUSION: Runners with AT showed higher strike impulse, lower muscle strength of the plantar flexors, and higher clinical and functional damage.
- Is 12 months enough to reach function after athletes? ACL reconstruction: a prospective longitudinal study(2022) FELIX, Ellen Cristina Rodrigues; ALONSO, Angelica Castilho; BRECH, Guilherme Carlos; FERNANDES, Tiago Lazzaretti; ALMEIDA, Adriano Marques de; LUNA, Natalia Mariana Silva; SOARES-JUNIOR, Jose Maria; BARACAT, Edmund Chada; HERNANDEZ, Arnaldo Jose; GREVE, Julia Maria D'AndreaContext: Anterior Cruciate Ligament (ACL) injury is disabling in several sports because it causes knee instability and functional deficit. Usually, surgical treatments produce the best functional outcomes, however, sometimes they are not always able to fully restore stability and function.Objective: The objective of this study was to evaluate postural balance, muscle strength, and functional perfor-mance of young athletes with an ACL injury before and after ACL reconstruction. Design: This was a longitudinal observational prospective study. Method: 74 athletes, 60 men, and 14 women, aged between 16 and 45, divided into two groups: the Group-Lesion of ACL with 34 athletes (24.1 years) and the Group-Control with 40 athletes without ACL lesion (27.7 years old). All volunteers performed posturography, isokinetic dynamometry, and the Hop-Test. The ACL-Group was evalu-ated before and 12 months after the reconstruction and the control group was evaluated once.Results: The Postoperative ACL Group presented greater limb symmetry, 0.96 (+/- 0.12), than the preoperative ACL Group, 0.87 (+/- 0.17), p < 0.01 in the Hop-Test. In the posturography, the displacement area was smaller in the postoperative ACL Group, 19.85 (+/- 5.74), compared to the preoperative ACL Group, 24.20 (+/- 8.97), p < 0.01. In isokinetic dynamometry the torque peak was greater in the postoperative ACL Group, 0.91 (+/- 0.14), than in the preoperative ACL Group, 0.74 (+/- 0.15), p < 0.01.Conclusion: The functional outcomes increased in ACL reconstruction athletes after 12 months, but not at the same level as in the Control Group. The result indicates an incomplete functional recovery, adaptive changes in postural control after injury, reconstruction, and return to sport.
- Risk factors for overuse injuries in runners’ ankles: a literature review(2015) GREVE, Julia Maria D’Andréa; ANDERE, Nathalie Ferrari Bechara; LUNA, Natalia Mariana Silva; CANONICA, Alexandra Carolina; CRUZ, Ticiane Marcondes F. da; PETERSON, Mark; ALONSO, Angelica CastilhoINTRODUCTION: In spite of the numerous benefits to human health and given the increase of running as an exercise that has become popular worldwide, this type of sport may be the cause of a number of different injuries. The foot, ankle and lower leg comprise almost 40% of the injuries. However, the etiology of these types of injury is still not completely understood. OBJECTIVE: To investigate the causes of the onset of overuse injury in runners. METHODS: A systematic search of the electronic database was made: Bireme, Pubmed and PEDro, which were selected that addressed clinical trials, control cases, prospective and cross-sectional studies. RESULTS: The search through the descriptors yielded 324 references. Using our predefined inclusion criteria (case studies, clinical trials, prospective studies and cross studies that addressed adult runners, amateur or professional) 68 articles remained; 24 citations were excluded after reading the title, and 35 were excluded after reading the abstract and the full text. Therefore nine studies that met the criteria for analysis were included. CONCLUSION: The etiology of overuse injuries in runners is multifactorial. This review showed that distance, soil type and footwear, as well as a history of previous injuries, biomechanical changes such as increased dorsiflexion and eversion ankle, and greater knee flexion are risk factors that influence the occurrence of these injuries.
- IMPACT OF DIABETIC NEUROPATHY ON QUALITY OF LIFE AND POSTURAL BALANCE IN BRAZILIAN OLDER ADULTS(2020) ERNANDES, Rita de Cassia; BRECH, Guilherme Carlos; LUNA, Natalia Mariana Silva; BEGA, Armando; GUIMARAES, Danielle Serra; BOCALINI, Danilo Sales; SCHERRER JUNIOR, Gerson; GREVE, Julia Maria D'andrea; LEME, Luiz Eugenio Garcez; ALONSO, Angelica CastilhoObjective: To analyze the impact of the Peripheral Diabetic Neuropathy (PDN) on the postural and functional balance and quality of life of Brazilian older adults. Methods: A cross-sectional study. Sixty older men and women (60-79 years) were divided into three groups: control, DM without and with PDN. The following parameters were evaluated: anthropometry; quality of life; postural balance (BESTest); functional balance in force plate (NeuroCom Balance). Results: PDN group presented significant differences compared with the other groups, with the worst performance in quality of life than DM2 without PDN in: sensory functioning (p = 0.030); past and future (p = 0.036); death and dying (p = 0.035). Postural balance deficit in the total score (p = 0.025) and biomedical constraints section (p = 0.043) of the BESTest, comparedwith DM2 without PDN (p = 0.007). In the functional balance (Neurocom), PDN group presented a worse performance in the time spent on the left side (p = 0.030) than the control group. During step up over test, the control group performed the task faster than the group with PDN (p = 0.004). Conclusion: This study showed that neuropaths presented worse physical performance and postural balance deficits, sensorial limitations, affecting the daily tasks and, as a consequence, decreasing the quality of life in Brazilian older adults.
- Effects of treadmill training on gait of elders with Parkinson's disease: a literature review(2020) LUNA, Natalia Mariana Silva; BRECH, Guilherme Carlos; CANONICA, Alexandra; ERNANDES, Rita de Cassia; BOCALINI, Danilo Sales; GREVE, Julia Maria D'Andrea; ALONSO, Angelica CastilhoParkinson's disease is the second most common neurodegenerative disorder in old age. Aging process for elders with Parkinson's disease can induce gait disturbances with more functional disabilities than for elders without the disease. Treadmill training as a therapy has resulted in notable effects on the gait of patients with Parkinson's disease and may be a resource for geriatric neurological rehabilitation. This review aimed to study the effects on gait after treadmill training in elderly patients with Parkinson's disease. The search was performed in the databases PubMed (R), LILACS, PEDro and EMBASE, with the following keywords: ""Parkinson's disease"", ""elderly"", ""treadmill training"" and ""gait evaluation"". The quality of the studies included was assessed by PEDro Scale. Eleven studies met the inclusion and exclusion criteria. Eight studies were randomized, and only one did a follow-up. One can observe in this review that treadmill training with or without weight support (at least 20 minutes, two to three times a week, with progressive increase of loads, for minimum of 6 weeks) in elderly patients with the Parkinson's disease was effective to improve gait. In addition, both were considered safe (since some studies described the use of belts, even in unsupported training) and can be associated with therapies complementary to gait, such as repetitive transcranial magnetic stimulation, visual cues or anodal transcranial direct current stimulation. Treadmill training in elderly patients with Parkinson's disease is an intervention that improves gait outcomes, but further studies are required for better proofs.
- Isokinetic analysis of ankle and ground reaction forces in runners and triathletes(2012) LUNA, Natalia Mariana Silva; ALONSO, Angelica Castilho; BRECH, Guilherme Carlos; MOCHIZUKI, Luis; NAKANO, Eduardo Yoshio; GREVE, Julia Maria D'AndreaOBJECTIVE: To analyze and compare the vertical component of ground reaction forces and isokinetic muscle parameters for plantar flexion and dorsiflexion of the ankle between long-distance runners, triathletes, and non-athletes. METHODS: Seventy-five males with a mean age of 30.26 (+/-6.5) years were divided into three groups: a triathlete group (n = 26), a long-distance runner group (n = 23), and a non-athlete control group. The kinetic parameters were measured during running using a force platform, and the isokinetic parameters were measured using an isokinetic dynamometer. RESULTS: The non-athlete control group and the triathlete group exhibited smaller vertical forces, a greater ground contact time, and a greater application of force during maximum vertical acceleration than the long-distance runner group. The total work (180 degrees/s) was greater in eccentric dorsiflexion and concentric plantar flexion for the non-athlete control group and the triathlete group than the long-distance runner group. The peak torque (60 degrees/s) was greater in eccentric plantar flexion and concentric dorsiflexion for the control group than the athlete groups. CONCLUSIONS: The athlete groups exhibited less muscle strength and resistance than the control group, and the triathletes exhibited less impact and better endurance performance than the runners.
- ANTHROPOMETRIC FACTORS AND BODY COMPOSITION AND THEIR RELATIONSHIP WITH DYNAMIC BALANCE TESTS(2020) FERREIRA, Brenda Aparecida da Silva; BENETTI, Fernanda Antico; LUNA, Natalia Mariana Silva; BRECH, Guilherme Carlos; BOCALINI, Danilo Sales; MAIFRINO, Laura Beatriz Mesiano; MAGALDI, Fernanda; GREVE, Julia Maria D'Andrea; ALONSO, Angelica CastilhoIntroduction: The limit of stability is characterized by the maximum angle of inclination that an individual can reach and greater variability in extreme conditions; it is a bold and/or dangerous motor control strategy. Objective: Assess whether anthropometric measurements and body composition interfere with limits of stability and weight-bearing at different speeds in adults. Methods: Eighty-seven subjects of both sexes aged between 20 and 40 years were analyzed using anthropometric assessment and body composition. A force platform, limits of stability (LoS) and rhythmic weight shift (RWS) tests were used for the balance assessments. Results: In the LoS test, being female was negatively correlated with foot size and reaction time, and positively correlated with maximum excursion. In the RWS test, the female group had a negative correlation with height and upper limb length (ULL), with mediolateral directional control. The male group had a negative correlation with ULL and laterolateral directional control. Conclusion: Body composition variables do not interfere in the LoS and RWS tests in subjects with normal body mass index (BMI) values, except for bone densitometry (BMD) in women. As regards anthropometric parameters, height, ULL and foot size in the female and male groups were as follows: ULL and foot size exert little influence on postural balance control.
- Assessment of Postural Balance Among Individuals with Parkinson Disease with and Without Effects from Dopaminergic Medications(2014) GREVE, Julia Maria D'Andrea; LUNA, Natalia Mariana Silva; SIQUEIRA, Juliana Plato de; PROTA, Cristina; ALONSO, Angelica CastilhoObjective The objectives of the present study were to assess the effects of dopaminergic drugs on the postural balance of Parkinson disease (PD) patients and to ascertain whether their sway is greater along the mediolateral or the anteroposterior axis. Design Twenty-two patients awaiting operations for implantation of a deep brain stimulator at the neurology service of Hospital das Clinicas, University of SAo Paulo School of Medicine (HC-FMUSP), were assessed. All of them were assessed on the AccuSway(Plus) portable force platform, through evaluation of the center of pressure. The patients stayed standing upright on both feet with the eyes open and closed for 60-sec periods. Center-of-pressure displacements along the mediolateral and anteroposterior axes and the displacement velocity and the elliptical area covered by 95% of the displacement were measured. Two assessments were made: without medication (at least 12 hrs after the last administration) and with the effects from levodopa. Results The elliptical displacement area was greater when the patients were under the effects of the medication (P < 0.05). The center-of-pressure displacements were greater along the anteroposterior axis than along the mediolateral axis. Conclusions Levodopa increases the sway area of the Parkinson disease patients evaluated by static posturography.