GUILHERME CARLOS BRECH
Projetos de Pesquisa
Unidades Organizacionais
LIM/41 - Laboratório de Investigação Médica do Sistema Músculoesquelético, Hospital das Clínicas, Faculdade de Medicina
38 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 38
- Response to fatigue observed through magnetic resonance imaging on the quadriceps muscle in postmenopausal women(2020) BRECH, Guilherme Carlos; PAULA, Thalita Sousa de; FEDELE, Thiago Antonio; DIAS, Aluane Silva; SOARES, Jose Maria; BORDALO-RODRIGUES, Marcelo; BARACAT, Edmund Chada; ALONSO, Angelica Castilho; GREVE, Julia Maria D'AndreaOBJECTIVES: Menopause marks the end of women's reproductive period and can lead to sarcopenia and osteoporosis (OP), increasing the risk of falls and fractures. The aim of this study is to evaluate the influence of normal and low bone mineral density (BMD) on muscular activity, observed through inflammatory edema when mapping using magnetic resonance imaging (MRI) on the quadriceps muscle of postmenopausal women. METHODS: This was a cross-sectional study involving 16 older women, who were divided into two groups: osteoporosis group (OG), older women with OP, and control group (CG), older women without OP. The groups were evaluated in terms of nuclear MRI exam before and after carrying out fatigue protocol exercises using an isokinetic dynamometer and squatting exercises. RESULTS: The results of the present study showed that in intragroup comparisons, for both groups, there was a significant increase (p<0.05) in the T2 signal of the nuclear MRI in the quadriceps muscle after carrying out exercises using both thighs. In the intergroup comparison, no statistically significant difference was observed between the OG and CG, pre- (p=0.343) and postexercise (p=0.874). CONCLUSION: The acute muscular activation of the quadriceps evaluated by T2 mapping on nuclear MRI equipment is equal in women with and without OP in the postmenopausal phase. BMD did not interfere with muscle response to exercise when muscle fatigue was reached.
- 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.
- Brake response time between male drivers with and without paraplegia: Association between sociodemographic, motor and neurological characteristics(2021) SANTOS, Sileno; BRECH, Guilherme Carlos; ALONSO, Angelica Castilho; GREVE, Julia Maria D'AndreaObjective: The objective of this study was to compare the brake response time of drivers with paraplegia (who use hand control) with drivers without paraplegia (who use their feet) in a virtual driving simulator brake test. Additionally, we aimed to predict and evaluate the association of virtual brake response time with sociodemographic, motor and cognitive variables. Methods: 40 male adult drivers, with paraplegia (n = 20, mean age 38.1 +/- 3.6 years) and without paraplegia (n = 20, mean age 38.0 +/- 5.8 years), with valid driver licenses, had their brake response time evaluated in an automatic transmission car simulator. Non-disabled drivers were tested with conventional foot controls, while paraplegic drivers used hand controls. Drivers with paraplegia performed simple, choice and go/no-go reaction time tests as neuropsychological evaluations. Student's t-test was used to examine the differences of driving simulator brake response time between groups. Pearson coefficient verified the correlation of driving simulator brake response time with years of driving, length of disability, handgrip strength and neuropsychological tests of the paraplegic drivers. A regression model was developed to describe the mean of driving simulator brake response time using the backward elimination method for model adjustment selecting the explanatory variables. Results: Differences of simulator brake response time between groups were not statistically significant (non-paraplegic drivers = 0.90 seconds; paraplegic drivers = 0.92 seconds, p > 0.05). Years of driving significantly correlates with brake response time of paraplegic driver (r= -58, p = 0.009). Linear regression analyses indicated that years of schooling and years of driving (explanatory variables) explained 60.2% of driving simulator brake response time for the drivers with paraplegia. Driving simulator brake response time showed no difference between drivers with and without paraplegia. Years of driving and schooling were the main predictors of braking performance in drivers with paraplegia measured in a driving simulator.
- DYNAMIC POSTURAL BALANCE IS MEDIATED BY ANTHROPOMETRY AND BODY COMPOSITION IN OLDER WOMEN(2021) BRECH, Guilherme Carlos; FREITAS, Jessica Sillas de; GOUVEA, Marcia; MACHADO-LIMA, Adriana; BASTOS, Marta Ferreira; TAKAYAMA, Liliam; PEREIRA, Rosa Maria Rodrigues; GREVE, Julia Maria D'Andrea; ALONSO, Angelica CastilhoObjective: To investigate the relationship between anthropometry and body composition with dynamic postural balance in elderly women with low bone mineral density (BMD). Methods: 45 older women (>= 60 years), low BMD and nutritional diagnosis of low weight to overweight. For the assessment of body composition, Dual energy X-ray emission densitometry and anthropometric examination were used to measure: body mass (kg), height (cm) and BMI (k/m(2)). The assessment of dynamic postural balance was performed by the mini Balance Master Evaluation System clinical test and the computerized Balance Master (R) System test by the Sit to Stand and Step Up/Over tests. Results: There was a negative correlation between miniBESTest (r = - 0.566; p = 0.001) and time to ascend and descend step (r = - 0.393; p = 0.007) with fat mass, and positive correlation with miniBESTest (r = 0.526; p =0.001) and time to go up and down a step with muscle mass (r = 0.297; p = 0.04). As for anthropometric variables, only height showed a positive correlation (r = 0.296; p = 0.04) with the speed in the sit and stand test. Conclusion: Lean mass reduces postural oscillations; in contrast, fat mass negatively interfered with dynamic postural balance in women with low BMD. Height was related to dynamic postural balance, the taller the elderly, the worse their balance.
- 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.
- Prevalência de idade e gênero e sua correspondência com os setores de fisioterapia ambulatorial de um instituto de ortopedia e traumatologia de referência da cidade de São Paulo(2019) SILVA, David Vieira da; ANDRUSAITIS, Silvia Ferreira; FERNANDES, Livia Gaspar; MELO, Tamiris Barbosa de; CARVAS JUNIOR, Nelson; BRECH, Guilherme CarlosABSTRACT Regardless of the nature of accidents that occur daily, the consequences often require specialized rehabilitation. This study aims to verify which outpatient physical therapy sector of an orthopedics and traumatology institute has the highest prevalence of referral forms for care. In addition, it verifies which gender predominates and what is the relationship between age groups and the outpatient physical therapy sectors of a reference hospital in the municipality of São Paulo. This is a prospective study conducted between March and December 2016 with a sample of 1507 referral forms to the Physical Therapy Outpatient Clinic of the Institute of Orthopedics and Traumatology, Clinical Hospital of the Medicine School of University of São Paulo. The study showed that the Trauma sector for Outpatient Physical Therapy has a higher number of referral forms, the male gender was predominant, and the different age groups corresponded to each Outpatient Physical Therapy sectors.
- Positive correlation of postural balance evaluation by two different devices in community dwelling women(2016) BRECH, Guilherme Carlos; LUNA, Natália Mariana Silva; ALONSO, Angélica Castilho; GREVE, Júlia María D'AndréaOBJECTIVE: To establish the convergent validity or relationship of the Balance Master® as balance assessment device by comparing its performance results with those obtained from the AccuSway Plus® force plate. METHOD: Cross-sectional observational study, without intervention, of 126 postmenopausal women (60.3 ± 3.2 years; body mass index = 27.6 ± 4.7 kg/m2). Two devices were used for the independent assessments of static balance: (a) Static postural balance assessment (posturography) was performed on a force platform (AccuSway Plus); (b) static evaluation was performed on the Balance Master®System. The variables studied in the two devices, were: (i) the Mean Velocity of the Center of Pressure Displacement in all directions (Vavg or Mean Firm), (ii) the Anteroposterior (Mean-Y) and (iii) the Mediolateral (Mean-X) Centers of Pressure Displacement. The Spearman correlation coefficient was calculated to measure the correlation of the variables of balance obtained with the two different devices. RESULTS: Significant correlations were obtained when the relationships between both variables were described by fitting multiple linear regression models. There was an association between the mean velocity of center of pressure displacement in both devices, with eyes open (r = 0.21) and eyes closed (r = 0.47). In the eyes open condition, Vavg increased, on average, 0.26 units, while Mean Firm increased 1.0 unit; in the Mean-Firm; in eyes closed condition, Vavg increased, on average, 1.27 units, while Mean-Firm increased by 1,0 unit. CONCLUSION: The devices investigated presented a significant correlation for the mean velocity calculated from the total displacement of the center of pressure in all directions.
- Correlation of disability and pain with postural balance among women with chronic low back pain(2012) BRECH, Guilherme Carlos; ANDRUSAITIS, Silvia Ferreira; VITALE, Gabriela Faller; GREVE, Julia Maria D'Andrea