Papers by Vera Regina Fernandes Silva Marães
A multidisciplinary team is a determining factor in the prognosis of individuals who suffered sig... more A multidisciplinary team is a determining factor in the prognosis of individuals who suffered significant member loss. The surgical procedure directly affects the transfemoral amputees routine, causing several changes. The aim of this study was to analyze in the linear perspective and the nonlinear heart rate variability (HRV) during three different rest positions, during exercise and correlate its main indexes with functional measures. We studied seven patients with transfemoral amputation with mean age of 31.7 ± 7.53 years, body mass index (BMI) of 23.74 ± 3.58 kg / m2, amputation time of 6.21 ± 2.7 years and six minute walking test (6MWT) distance of 322.29 ± 61,74m. Initially, they underwent evaluation by the International Physical Activity Questionnaire (IPAQ) in its short version, a functional assessment questionnaire for amputees (AMF) was investigated and the existence of metabolic risk through correlation measures. Later data of HRV were collected and stored using a heart monitor (POLAR-S800) during supine position, sitting, standing for 10 minutes and during the 6MWT. Under the linear perspective, the RMSSD and pNN50 rates, global indicators of the activity of the parasympathetic system, were used in the time domain and the Low frequency components (LF), high frequency (HF) and LF / HF ratio corresponding to the frequency domain, respectively indicating the sympathetic activity, parasympathetic and their relation. The nonlinear variables selected were the SD1 and SD2 used as indices representing parasympathetic instant and long-term, respectively, and the indices α1 and α2, indicators of the cardiovascular system normality, also instantaneous and long-term and the value of approximate entropy (ApEn) indicator system organization level. For comparative statistic analysis we used Wilcoxon test, correlation coefficient Spearman and Pearson Chi-Square test for nonparametric variables using SPSS (SPSS (Statistical Package for Social Sciences, Chicago, IL, USA) version 18 and the HRV data collected were collected using the Polar ProTrainer 5® program and analyzed using the Kubius program (HRV Kubios 2.1 release). Subjects were considered predominant active with traumatic amputation without metabolic risk and did not seem to present problems related to the use of the prosthesis, the non-amputated member, the residual limb (stump) viii and locomotion. Regarding the HRV, volunteers have a healthy cardiovascular system due to the values α1 and α2 near one and sympathetic predominance in all resting positions with a slight increase during exercise. Comparing the resting positions, a greater parasympathetic activity in lying and sitting positions relative to stand up and sympathetic predominance in the standing position and sitting when compared to supine. In comparing the resting conditions and exercise, the parasympathetic component to the long-term was lower during the 6MWT. There were no correlations between variables "time of amputation", "distance", "age" and "mobility score." By correlating the types of HRV analysis, strong correlations were found between rMSSD indexes, AF, BF SD1 and SD2 with the values as well as between the cardiac system normality indicators α1 and α2 with the sympathetic markers. The standing position has produced significant changes in the autonomic control of the volunteers when compared to lying position. Exhibiting similar behavior to individuals without amputation, where the parasympathetic system dominates at the lying position and decreases when standing. Such behavior was observed in linear and non-linear context. We also observed strong correlations between the two types of analysis, highlighting the rMSSD, HF and LF indexes. The components in the frequency domain also appear to influence the organization of the system and the parasympathetic activity seems to be related to cardiovascular health of the individual.
International Journal of Biomedical Engineering and Technology, 2015
This study aimed to assess the electromyographic feasibility of different hip muscles on transfem... more This study aimed to assess the electromyographic feasibility of different hip muscles on transfemoral unilateral lower limb amputees to a possible control of artificial limbs. The volunteers were split into two groups: eight males, physically active amputees and a control group composed of eight males, healthy, non-amputees individuals. The hip muscles were assessed in accordance to the general consensus by SENIAM project, and some adaptations were made in the amputees when the anatomical references were absents, such as the knee articulation. Thus, agonists and antagonists skeleton muscles were evaluated during the isometric contraction of hips movements of extension and flexion, which were controlled by an isokinect chair. The median frequency (F med) values did not represent significant differences and the RMS is the best muscle activity of amputees.
XXVI Brazilian Congress on Biomedical Engineering, 2019
Amputation is defined as the loss of part of an individual’s limb. Its high incidence makes that ... more Amputation is defined as the loss of part of an individual’s limb. Its high incidence makes that the researches and search for the improvement of the devices that help it during the accomplishment of the activities of daily life can be each day more improved. Therefore, the aim of the research is to determine the best placement of reflexive markers on the individual’s skin. The research method was supported by Qualisys Track Manager (QTM) along with the support of several other software that aided in analyzing the data (Anaconda, Juper, Open Gait Analytics). This protocol was thought and referenced by authors who were dedicated to understanding the best points of reflexive markers in the patient’s body, where these authors studied the important anatomical points for the collection and better capture of the images. The sites of placement of the markers determined after due analysis of the studies of these authors were in the hip, thigh, knee, leg, and ankle. The protocol was tested and validated by the researchers and in this way was continued in the analysis. The result evidenced the angles found during the process of ambulation of the individual. It is hoped that with this research it will be possible to complete all the proposed objectives so that in the end one can propose improvements in the quality of life of the amputees.
Advances in Intelligent Systems and Computing, 2019
The study of heart rate variation (HRV), also called cardiac frequency variability, is used to id... more The study of heart rate variation (HRV), also called cardiac frequency variability, is used to identify the range of samples where the respiratory sinus arrhythmia occurs and presents information of low frequency (LF) and high frequency (HF) densities. Cardiofrequency meters (Polar WearLink) are widely used heart rate monitors in sports and clinical practice. The sensor registers the values of the R waves (RR) intervals of the electrocardiogram (ECG) to be analyzed by the specialist. This process can introduce errors and deletion of important data due to human error. This work aims at designing a computational system to analyze the non-stationary signals to aid the specialist in cardiovascular diagnosis. The methodology is performed in three steps: (1) pre-processing with a compact support median filter to get rid of the outliers, then passing through a mapping of RR intervals to beats per minute (bpm) to verify maximum frequency, tachycardia and bradycardia in the time domain. To determine the outliers, a threshold is chosen to be applied to the bpm values according to the minimum and maximum values of the normal RR intervals, which depend on genre and age; (2) process with Spectrograms and continuous and discrete Wavelet transforms to improve the diagnosis; (3) visual interpretation of these results by the specialist by verifying that these results are consistent. The results, with the available data from the volunteers, show that the system proved to be consistent to help the specialist improve the accuracy in the cardiovascular diagnosis.
Introducao: A pratica de atividades desportivas como danca, permite que o individuo aumente sua q... more Introducao: A pratica de atividades desportivas como danca, permite que o individuo aumente sua qualidade de vida, melhora os aspectos psicologicos, aumentando integracao e convivio social, aumenta a capacidade muscular e cardiorrespiratoria. O projeto Danca No Parque e uma atividade da LIFICAR, onde ha a participacao de adultos idosos hipertensos e normotensos, de ambos os sexos, saudaveis, sem limitacoes funcionais.A danca surge como um fator de protecao e promocao de saude, bem como um controle e melhoria do sistema cardiovascular. E observada se ha existencia de alteracoes significativas sobre o sistema cardiovascular em uma populacao de adultos hipertensos e normotensos. Descricao: O projeto Danca No Parque consiste num programa de terapia de danca, duas vezes na semana com duracao de duas horas. As sessoes possuem quatro momentos: coleta de dados cardiovasculares; aquecimento; a terapia de danca com duracao cinquenta minutos, em que sao ensinados aos voluntarios os estilos for...
INTRODUCAO: O curso de graduacao em Fisioterapia, iniciado no Brasil em 1929, passou por diversas... more INTRODUCAO: O curso de graduacao em Fisioterapia, iniciado no Brasil em 1929, passou por diversas mudancas, ampliando as areas de atuacao o que resultou em maior autonomia, crescimento de demanda e visibilidade (BISPO JUNIOR; 2009; PEREIRA, ALMEIDA 2006). Desta forma o numero de Instituicoes de Ensino Superior (IES) no pais, que ofertam a graduacao na area vem crescendo, o que pode ser constatado no sistema eletronico do Ministerio da Educacao (e-MEC), disponivel para o acesso publico. Entretanto a evolucao e a distribuicao regional destes cursos, bem como, as suas caracteristicas e pouco conhecida. OBJETIVOS: Objetivo: Analisar a distribuicao territorial e descrever as caracteristicas dos cursos de graduacao em Fisioterapia no Brasil. METODOLOGIA: Realizou-se a coleta de dados no sistema virtual do Ministerio da Educacao (emec.mec.gov.br), em duas etapas. A primeira foi uma consulta textual – catalogando as unidades segundo o nome do curso; a segunda etapa foi uma consulta pela obs...
Introducao: A Liga Academica de Fisioterapia Cardiovascular da Universidade de Brasilia - UnB (LI... more Introducao: A Liga Academica de Fisioterapia Cardiovascular da Universidade de Brasilia - UnB (LIFICAR - UnB), implementada em 2014 na plataforma SIEX - UnB, registrada como acao de extensao da universidade, realizou em outubro de 2017 seu segundo Simposio Multidisciplinar. Organizado pelos proprios academicos, o Simposio contou com palestras e minicursos com temas relacionados ao sistema cardiorrespiratorio e atuacao dos fisioterapeutas nesta area.Demonstrar a importância de atividades academica como o Simposio Multidisciplinar na vida dos estudantes de fisioterapia. Descricao: Durante o primeiro semestre de 2017, os alunos da LIFICAR se empenharam em organizar seu Segundo Simposio Multidisciplinar, realizado na Universidade de Brasilia no periodo de 4 a 7 de Outubro, foram convidados diversos profissionais da area da saude para palestrarem e darem aulas nos minicursos de Ergoespirometria, Reabilitacao Cardiaca, Gasometria, Parada Cardiorrespiratoria e Ventilacao nao invasiva. Impa...
INTRODUCAO: A liga academica de Fisioterapia Cardiovascular da Universidade de Brasilia - UnB (LI... more INTRODUCAO: A liga academica de Fisioterapia Cardiovascular da Universidade de Brasilia - UnB (LIFICAR - UnB), foi implementada no ano de 2014 na plataforma SIEX - UnB, sendo registrada como uma acao de extensao da universidade, sendo esta a primeira liga academica do curso de fisioterapia da UnB, desenvolvida por academicos. Atualmente a liga apresenta uma professora pos doutora como coordenadora e orientadora. Apesar de ser uma liga do curso de fisioterapia, a LIFICAR possui ligantes de varios cursos da area da saude, incentivando a atuacao multidisciplinar. DESCRICAO DA EXPERIENCIA: Durante os tres ultimos anos, a LIFICAR vem atuando nas Feiras de Saude do Hospital Universitario de Brasilia desenvolvendo atividades de prevencao e promocao em saude, atraves da estratificacao de riscos de desenvolvimento de doencas cardiovasculares, orientacoes alimentares, e sobre a pratica de atividades fisicas, alem de realizar afericoes de pressao arterial e entregar informativos que contem ori...
INTRODUCAO: A primeira partida de futebol americano ocorreu em 1869, porem apenas quase um seculo... more INTRODUCAO: A primeira partida de futebol americano ocorreu em 1869, porem apenas quase um seculo mais tarde, 1960, que observou-se o crescimento dessa modalidade esportiva. No Brasil, o futebol americano vem se destacando e conquistando seus adeptos e fas. O futebol americano e caracterizado por esforcos intermitentes de alta e baixa intensidade. Durante a partida os jogadores relatam a necessidade de exercicios de explosao ocorrendo alteracoes hemodinâmicas em funcao as demandas impostas. Embora essas alteracoes durante o exercicio aerobico estejam bem documentadas, ha uma escassez de dados quando baseado em atletas, principalmente na modalidade do futebol americano no Brasil. A experiencia teve como objetivo avaliar a alteracao da frequencia cardiaca (FC) e desempenho dos atletas de futebol americano do time Templarios-DF durante o treino de tiro de 50 metros e relatar a importância da acao para o time. DESCRICAO DA EXPERIENCIA: Ampliando o campo de atuacao da Liga academica de F...
INTRODUCAO: O teste de exercicio cardiopulmonar apresenta inumeras variaveis que permitem analise... more INTRODUCAO: O teste de exercicio cardiopulmonar apresenta inumeras variaveis que permitem analises dos sistemas cardiovasculares, respiratorio e muscular, tendo como uma das principais mensuracoes a do volume de oxigenio maximo (VO2). Tendo em vista que a amputacao ocasiona mudancas estruturais, mecânicas e metabolicas para adaptar-se ao membro residual, acredita-se que o consumo de oxigenio desses individuos seja alterado. OBJETIVO: Analisar o consumo de oxigenio de amputados transfemorais e seus impactos ao sistema cardiovascular durante teste cardiopulmonar. METODOLOGIA: Realizou-se testes de exercicio cardiopulmonar em oito amputados tranfemorais unilaterais em uso de protese (media 31 anos e 2,061 Desvio Padrao), ativos 4 ativos e 4 muito ativos (Questionario Internacional de Atividade Fisica - IPAQ). Foram realizados testes cardiopulmonar em cicloergometro (Corival Quinton Equipamentos Ltda) com protocolo de rampa com mensuracao de esforco pela escala de BORG, utilizando ergoe...
Machine Learning (ML) has drawn a lot of attention these days due to its capability to automate p... more Machine Learning (ML) has drawn a lot of attention these days due to its capability to automate processes that where very complicated and/or only performed by humans before. It is done by not having the need to write hard coded rules to solve problems, letting the machine find the rules by itself, and for being able to universally approximate functions with certain algorithms. On the other side, motion capture systems are quite expensive, making it more difficult to health professionals and physicians to have a more precise way to analyze the gait of patients and the diseases related to it. Having that said, this paper aimed to show that is possible to predict (generate) the angles of the right knee of patients directly from a common video of their walks, reducing costs and opening the opportunity for a more complete and affordable system to realize motion capture. Thus, this study is an initial experiment and the first step towards a possible future more complete product. As an ini...
Revista Brasileira de Ciência e Movimento, 2020
O aumento do número de sujeitos amputados protetizados torna necessário o desenvolvimento de disp... more O aumento do número de sujeitos amputados protetizados torna necessário o desenvolvimento de dispositivos cada vez mais seguros e funcionais para o uso. Dentre os aspectos envolvidos no desenvolvimento protético, é importante que seja avaliada a percepção do usuário em relação ao dispositivo para detectar problemas e desconfortos que prejudicam o processo de adaptação e reinserção social após a amputação. Objetivo: analisar o nível de satisfação de atletas com amputação transfemoral em relação à suas próteses e seus impactos em sua funcionalidade e qualidade de vida. Método: Estudo transversal preliminar realizado com atletas amputados, a coleta de dados foi realizada por meio da aplicação de um formulário de avaliação estruturado e questionário para obtenção das características estruturais e psicológicas dos participantes com amputação e do dispositivo protético utilizado, o nível de associação entre os aspectos avaliados foi medido por meio do coeficiente de correlação de Spearman...
Revista Brasileira de Medicina do Esporte, 2020
Introduction Sitting volleyball is an adapted sport played by players in the seated position, due... more Introduction Sitting volleyball is an adapted sport played by players in the seated position, due to impaired mobility or amputations. Court dimensions are adjusted to the players’ average height, and during the games, the actions performed are similar to those of traditional volleyball. Objective To analyze the tactical performance of lower limb amputees and physically disabled athletes during seated volleyball games. Methods Data were collected from video footage, by a single observer, of twelve games of the Brazilian north-northeast championship 2017. The analysis investigated: i) average length of rallies; ii) frequency of attack actions; iii) game actions by amputation type; iv) outcomes of the actions by amputation type; v) direction and frequency of movements by disability. Results The average duration was 70 rallies per game, with the minimum disabled athletes performing the highest number of attack actions (43). Transfemoral amputees performed the highest number of blocking...
Fisioterapia em Movimento, 2020
Introduction: The course pedagogical projects (CPPs) of physical therapy programs in Brazil are b... more Introduction: The course pedagogical projects (CPPs) of physical therapy programs in Brazil are based on National Curriculum Guidelines for Physiotherapy (NCGP) and the principles of the National Health System (SUS). The CPPs that guide professional training tend to use a biopsychosocial approach and propose familiarizing undergraduate students with the International Classification of Functionality, Disability and Health (ICF); as such, they should include the use of this instrument. Objective: Assess CPPs by exploratory document analysis and determine whether they propose teaching and using the ICF in student training. Method: Qualitative-quantitative study with document analysis of CPPs for physical therapy courses in Midwest Brazil, from which information related to the ICF was extracted. Results: The biopsychosocial model and NGCP were identified in the 10 CPPs analyzed and the ICF was found in the curriculum outline of 6 of these, indicating the incorporation of this framework ...
Journal of Health Sciences, 2019
Heart rate variability (HRV) analysis is an important method to evaluate the modulation of autono... more Heart rate variability (HRV) analysis is an important method to evaluate the modulation of autonomic nervous system on cardiac activity. The goal was to evaluate the heart rate variability behavior in hypertensive middle-aged men at rest, before and after submaximal physical test. It is a cross-sectional, analytical study with sedentary men, middle-aged (mean 48 years) and owners of clinical diagnosis of hypertension who underwent to a physical therapy evaluation, and obtainment of HRV at rest in the supine position, sitting position and before a 6-minute walk test and after it. The values of HRV indexes on time and frequency domain showed low and statistically significant (p<0.05) when analyzed and compared at rest and after the execution of the test. Conclusion: The data suggest that the studied hypertensive volunteers showed a reduction of HRV immediately after the 6-minute walk test, implying a reduction in parasympathetic modulation during this period and the consequent incr...
Fisioterapia Brasil, 2017
Objetivo: Reunir os achados na literatura sobre eletromiografia, força muscular e alterações meta... more Objetivo: Reunir os achados na literatura sobre eletromiografia, força muscular e alterações metabólicas em amputados transtibiais. Métodos: Revisão sistemática da literatura, realizada no período de janeiro a março de 2014, com pesquisa nas bases de dados eletrônicas: Pubmed, Scielo, Lilacs, BVS, Dedalus e BCE; utilizando-se as palavras-chave: amputado transtibial, EMG, abaixo do joelho, amputados, força muscular, gasto energético e frequência cardíaca, além de seus correspondentes na língua inglesa. Resultados: Foram identificados 144 artigos. Após análise e avaliação, 33 artigos foram selecionados. A demanda metabólica apresenta-se maior durante a marcha de indivíduos amputados em comparação a não amputados. Para o estudo eletromiográfico nessa população são utilizados, principalmente, os músculos bíceps femoral e reto femoral. O torque foi a variável mais descrita por sua relação direta com a força muscular. Conclusão: Os sinais EMG estão fortemente relacionados ao modo como o a...
Acta Fisiatrica, Jun 1, 2011
This study aimed to analyze the relationship between maximal isometric grip strength and muscle s... more This study aimed to analyze the relationship between maximal isometric grip strength and muscle spasticity in paretic upper limbs. Thirty-three (33) patients with clinical diagnosis of stroke (CVA) in different stages of sensorimotor recovery, of both sexes with a mean age of 50.84 (± 13.69 years), participated in the study and were treated at Campinas University Hospital-SP or in rehabilitation centers. The following data was collected from a single session of a cross-sectional study: a)-maximal isometric grip strength using a hydraulic dynamometer with three alternate attempts for each limb, b) degree of spasticity of 8 muscle groups of the paretic upper limb (AS) measured by the Ashworth scale. Items from the Fugl-Meyer scale of upper limb physical performance were consulted for sample characterization (UE-FMA) for the assessment of sensorimotor recovery; the level of functional independence was assessed using the Barthel Index, and functional capacity using the Action Research Arm Test (ARA). Grip strength was measured with a dynamometer to acquire the mean and best value of three attempts using the paretic limb (weaker) and the stronger limb (non-paretic). There were no statistical differences between the three trials for both the weaker upper limb and the stronger one (p> 0.05). Nine participants of the sample presented normotonia in all studied muscle groups, while the presence of hypertonia of at least a level 3 in a muscle group was observed in nineteen participants. Grip strength was significantly higher on the stronger side (p <0.05) and the values from both upper limbs were below literature normative values for normal individuals of the same sex, age and side tested. The mean value of the "stronger" upper limb grip was 31.17 Kgf(± 10.22) and that of the paretic limb was 10.88 ± 8.82 Kgf. Only a weak correlation between muscle strength and muscle tone of evaluated muscles was seen, including flexor muscles of the fingers, thumb adductors and elbow flexors (r <0.60). These data suggest that the hydraulic dynamometer can be used to measure muscle strength in patients with weak grip according to the protocol presented. Additionally, it is suggested that muscle weakness is not related to the degree of muscle hypertonia in hemiparetic patients after stroke, but that hypertonic patients have essentially weaker muscles.
Creative Education, 2015
The formation of Occupational Therapists has become the subject of analysis and debate in recent ... more The formation of Occupational Therapists has become the subject of analysis and debate in recent decades after several changes in health policies in Brazil, among them the implementation of the National Curriculum Guidelines (NCGs) directing teaching practices in line with the Health Unic System and International Classification of Functioning, Disability and Health (ICF). Given these paradigms, the Occupational Therapy courses passed with several adjustments in their course of pedagogical political projects (PPPs) and their teaching practices. The study's goal was to characterize the Occupational Therapy courses and analyze their PPPs focusing on changes in the health care model and the inclusion of ICF. The research was exploratory and was conducted through documentary analysis. By 2013 there were 63 occupational therapy courses working in the country, 44 in private institutions and 19 in public, demonstrating a lack of supply in public. The Occupational Therapy courses are still guided by the biomedical model, and the applicability of the ICF as well as the insertion of the biopsychosocial model are incipient in teaching practice.
Creative Education, 2015
The goal of this study was to analyze the territorial distribution and describe the characteristi... more The goal of this study was to analyze the territorial distribution and describe the characteristics of undergraduate courses in Physical Therapy in Brazil. Data collection was performed using the virtual system of the Ministry of Education (emec.mec.gov.br) where we sought the following information: name of the institution, state, course load, note the National Examination Performance Students (NEPS), course concept (CC) and other relevant information (steps, extinction, among others). They found 601 Physical Therapy courses. The results show that there is a higher concentration of Physical Therapy courses in the Southeast, the workload and payment time cater to Resolution No. 4 of 6 April 2009 the Ministry of Education (MEC) and also that most courses have satisfactory grades in evaluation of MEC. It is noteworthy that most of the courses are still without concept, like, have an insufficient sample in NEPS or do not complete the evaluation cycle of the National Assessment System of Higher Education in Brazil.
INTRODUCAO: A Classificacao Internacional de Funcionalidade, Incapacidade de Saude (CIF) trata-se... more INTRODUCAO: A Classificacao Internacional de Funcionalidade, Incapacidade de Saude (CIF) trata-se de uma classificacao que permite a verificacao das condicoes em saude do individuo, passeando sobre os dominios de funcoes e estruturas do corpo, atividade e participacao e fatores ambientais, verificando para cada dominio, os agentes facilitadores e incapacitantes. A Organizacao Mundial da Saude, SUS e COFFITO preconizam o uso da CIF, de forma a abranger aspectos estatisticos, investigacao clinica, politica social e pedagogica, valorizando assim o modelo biopsicossocial em detrimento do modelo biomedico reducionista. Com isso, o curso de Fisioterapia da Universidade de Brasilia insere essa classificacao em algumas disciplinas afim de treinar os discentes ao uso da classificacao como ferramenta clinica. Objetivos: Apresentar a experiencia de aplicacao da Classificacao Internacional de Funcionalidade e Incapacidade durante disciplinas na Universidade de Brasilia. DESCRICAO DA EXPERIENCIA...
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Papers by Vera Regina Fernandes Silva Marães