GUILHERME CARLOS BRECH
Projetos de Pesquisa
Unidades Organizacionais
LIM/41 - Laboratório de Investigação Médica do Sistema Músculoesquelético, Hospital das Clínicas, Faculdade de Medicina
5 resultados
Resultados de Busca
Agora exibindo 1 - 5 de 5
- Postural control during single leg stance in individuals with clinical indication for combined reconstruction of the anterior cruciate and the anterolateral ligaments of the knee: a cross-sectional study(2022) NOVAES, Marilia; CARVALHO, Adriana; SAUER, Juliana F.; BRECH, Guilherme C.; HELITO, Camilo P.; JOAO, Silvia M. A.Background Several studies have shown persistent postural control deficits and rotatory instability in patients after isolated Anterior Cruciate Ligament (ACL) reconstruction. There is evidence to support that the Anterolateral Ligament (ALL) plays an important role in the remaining anterolateral rotatory laxity of the knee. There are no further evidences in order to understand how patients with a combined ACL + ALL reconstruction surgery indication behave regarding postural control. The aim of this cross-sectional study was to assess if patients with a clinical indication for the combined ACL + ALL surgery showed a deficient postural control in single leg stance compared to subjects with a regular ACL reconstruction indication and to a control group. Methods An assessment of static postural control on single leg stance was performed on a force plate, with eyes open and closed, and the center of pressure (COP) displacement variables were analyzed: maximum and mean amplitude in anteroposterior (AP) and in mediolateral (ML) direction; mean velocity of displacement and area of displacement. Eighty-nine male individuals participated and were divided into 3 groups: ACL Group, ACL + ALL Group and Control Group. Results The ACL+ ALL Group showed significantly greater COP displacement in most variables in the injured leg for the eyes closed test, compared to the ACL Group, as detailed: Total ML displacement (9.8 +/- 6.77 vs. 13.98 +/- 6.64, p < 0.001); Mean ML displacement (2.58 +/- 2.02 vs. 3.72 +/- 1.99, p < 0.001); Total AP displacement (9.5 +/- 3.97 vs. 11.7 +/- 3.66, p = 0.001); Mean AP displacement (1.77 +/- 0.87 vs. 2.27 +/- 0.86, p = 0.001); Area of displacement (111.44 +/- 127.3 vs. 183.69 +/- 131.48, p < 0.001). Conclusion Subjects with a clinical indication for ACL + ALL combined reconstruction surgery showed increased COP displacement compared to patients with indication for an ACL isolated reconstruction surgery.
- 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.
- The variability of isokinetic ankle strength is different in healthy older men and women(2022) BERSOTTI, Felipe Marrese; MOCHIZUKI, Luis; BRECH, Guilherme Carlos; SOARES, Andre Luiz de Seixas; SOARES-JUNIOR, Jose Maria; BARACAT, Edmund Chada; GREVE, Julia Maria D. 'Andrea; ALONSO, Angelica CastilhoContext: In the elderly, weak lower limb muscles impair functional tasks' performance. Objective: To evaluate the healthy elderly's ankle dorsiflexion and plantarflexion maximum torque and its variability in two sets of 5 RM isokinetics evaluation. Method: 50 women (68.0 +/- 4.6 years old) and 50 men (72.7 +/- 8.5 years old) did two sets of ankle plantar flexor and dorsiflexor isokinetic tests at 30 degrees/s. Peak torque, total work, and coefficient of variation were analyzed. Results: Men did the strongest plantarflexion torque (p < 0.05) and dorsiflexion torque (p < 0.05); their highest peak torque occurred at set 2 (p < 0.05), while the largest plantarflexion torque variability (p < 0.05), dorsiflexion torque variability (p < 0.05), and the largest plantarflexion torque variability occurred at set 1 (p < 0.05). Men did the highest plantarflexion and dorsiflexion total work (p < 0.05) at set 2 (p < 0.05). Conclusion: Older men are stronger than older women. The torque variability, in men, was higher during the first set, suggesting an adaptation to the isokinetics evaluation. Clinicians and researchers should consider that different muscles might need different numbers of sets and trials to measure their maximal muscle strength.
- Influence of invertor and evertor muscle fatigue on functional jump tests and postural control: A prospective cross-sectional study(2022) CASTILLO, Gabriela Borin; BRECH, Guilherme Carlos; LUNA, Natalia Mariana Silva; TARALLO, Fernanda Botta; SOARES-JUNIOR, Jose Maria; BARACAT, Edmund Chada; ALONSO, Angelica Castilho; GREVE, Julia Maria D'AndreaObjective: Fatigue of the ankle's stabilizing muscles may influence the performance of functional activities and postural control. The purpose of this study was to evaluate the performance of healthy young adults using functional jump tests and static posturography control under pre-and post-fatigue conditions of the ankle invertor and evertor muscles. Methods: Thirty physically active healthy male and female (15 male and 15 female) volunteers (24.3 years) were enrolled in this prospective cross-sectional study. Participants performed tests on one day under a non-fatigued state of invertor and evertor muscles and on the second day in a fatigued state. Tests included static posturography on a force platform in a bipedal stance with eyes open and closed and in one-legged support with eyes open and functional jump tests (figure-of-8, side hop, 6-m crossover hop, and square hop). Fatigue of the ankle invertor and evertor muscles was induced using isokinetic dynamometry with 30 repetitions at 120 degrees/s. Results: Participants had an average age of 24.3 years (SD +/- 2.08), the height of 1.73 m (SD +/- 0.08), and a weight of 68.63 kg (SD +/- 10.29). The average Body Mass Index (BMI) was 22.88 (SD +/- 2.46). A decrease in performance was observed in functional activities and postural control under all conditions after the induction of muscle fatigue, except for the speed at a bipedal stance with eyes open. Conclusions: Functional jump tests are low cost and useful for clinical practice and evaluation of the effects of muscle fatigue and could be used in clinical practice.
- Changes in postural balance associated with a woman's aging process(2022) BRECH, Guilherme Carlos; BOBBIO, Tatiana Godoy; CABRAL, Kelem de Negreiros; COUTINHO, Patricia Mota; CASTRO, Leila Regina de; MOCHIZUKI, Luis; SOARES-JUNIOR, Jose Maria; BARACAT, Edmund Chada; LEME, Luiz Eugenio Garcez; GREVE, Julia Maria D'Andrea; ALONSO, Angelica CastilhoContext: Aging causes a progressive worsening in postural balance, affecting functional independence and increasing the risk of falls. Objective: The aim of the study was to evaluate the effect of aging on the static balance in women from 50-years to 89-years of age. Design: This was a cross-sectional study, with 400 irregularly active women were evaluated and grouped by age: Group 6(th) decade (age 50 to 59) - 58 participants; Group 7(th) decade (age 60 to 69) - 214 participants; Group 8(th) decade (age 70 to 79) - 92 participants; Group 9(th) decade (age 80 to 89) - 36 participants. Postural balance was evaluated using a portable force platform in a standard standing position, with Eyes Open (EO) and Eyes Closed (EC). Results: In the two measurement conditions, the elderly women in Group 9(th) decade presented mediolateral displacement and range, and mean velocity greater than the women's values in Groups 6(th) and 7(th) decade. In the EO e EC situation, the displacement was higher in the elderly Group 9(th) decade compared to younger groups. Group 8(th) has a mean velocity greater than Group 6(th) decade in the EO situation. Conclusions: Posturography showed a decline in postural balance with advancing age, suggesting that the 9th decade of life is a borderline age to this detriment due to an increase in postural instability.