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Aims and background: To evaluate the effect of sleeping in the lateral decubitus position on the average thickness of the retinal nerve fiber layer (RNFL) in the peripapillary region of the optic nerve since the effect of posture on intraocular pressure (IOP) and glaucoma progression is not yet sufficiently understood. Materials and methods: A cross-sectional observational study was carried out with 40 volunteers who preferably slept in a right lateral decubitus (RLD) (RLD group N = 20) and left lateral decubitus (LLD) (LLD group N = 20) position. IOP was measured in both eyes, first in the sitting position and again after 10 minutes in a supine position, right lateral, and LLD, respectively. The mean thickness of the RNFL and the vertical papillary cup were measured by optical coherence tomography. Results: The average age of the volunteers was 60.53 ± 7.26 years. There were 32 female and eight male. There was an increase in IOP with the change from the sitting position to the lateral decubitus of 2.7 and 3.6 mm Hg in the RLD group (p < 0.001) and an increase of 3.0 and 3.15 mm Hg in the LLD group (p < 0.001), right eye (RE) vs left eye (LE), respectively. However, there was no difference in IOP values between the groups. The average thickness of the RNFL was in the RLD group-75.10 vs 78.05 µm (p = 0.325) and in the LLD group-81.55 vs 79.95 µm (p = 0.580). Vertical papillary excavation was in the RLD group-0.70 vs 0.65 (p = 0.175) and in the LLD group-0.65 vs 0.65 (p = 1.000), RE vs LE, respectively. Conclusion: We found no relationship between the lateral decubitus position when adopted preferentially for sleeping and the reduction of the RNFL. Clinical significance: Search for risk factors for the asymmetrical development of glaucoma, especially in well-controlled IOP in daytime measurements. How to cite this article: Vaz RT, Montenegro AAL, Quintas Segundo ADS, et al. Effect of Sleeping Position on the Retinal Nerve Fiber Layer in Individuals with Glaucoma. J Curr Glaucoma Pract 2024;18(2):57-62.

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PURPOSE: To assess the repeatability, intra and interrater reproducibility of the DIPA-S eHealth© system for capturing and measuring clinical variables of scoliosis, including frontal trunk imbalance (FTI), sagittal trunk imbalance (STI), and angle of trunk rotation (ATR). METHODS: Patients were photographed using the DIPA-S eHealth Capture© mobile application by family members, physiotherapists, or surgeons. Three photos were taken in each position: standing in the frontal and sagittal planes and in the axial plane in forward bending position of the trunk. The photos were analyzed by three independent evaluators using the DIPA-S eHealth Analysis© software. For repeatability, each photo was analyzed twice consecutively by the three evaluators. For intrarater reproducibility, only one evaluator reanalyzed the first photo from each plane with a 5-day interval. For interrater reproducibility, the three evaluators analyzed the first photo from each plane. The intraclass correlation coefficient (ICC), standard error of measurement (SEM), and minimal detectable change (MDC) were used (p < 0.05). RESULTS: The sample comprised 262 images (n = 30). Repeatability was excellent for all three evaluators in all three planes (ICC 0.94 to 1.00). Intrarater reproducibility was excellent in all three planes (ICC 0.88 to 0.99). Interrater analysis was excellent for the frontal and axial planes (ICC 0.98 and 0.93), respectively. However, it was weak in the sagittal plane ICC 0.32. The SEM ranged from 0.02 to 17.6 and MDC from 0.03 to 34.6. CONCLUSION: The DIPA-S eHealth© Capture and Analysis system demonstrates reproducibility for use in the clinical assessment of scoliosis through teleconsultations.

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BACKGROUND: The static sitting position contributes to increased pressure on the lumbar intervertebral disc, which can lead to dehydration and decreased disc height. OBJECTIVE: To systematically investigate the of sitting posture on degeneration of the lumbar intervertebral disc. MATERIALS AND METHODS: One researcher carried out a systematic literature search of articles with no language or time limits. Studies from 2006 to 2018 were found. The searches in all databases were carried out on January 28, 2022, using the following databases: Pubmed, Scopus, Embase, Cochrane, and Physiotherapy Evidence Database (PEDro) databases, and for the grey literature: Google scholar, CAPES Thesis and Dissertation Bank, and Open Grey. The acronym PECOS was used to formulate the question focus of this study: P (population) - male and female subjects; E (exposure) - sitting posture; C (comparison) - other posture or sitting posture in different periods; O (outcomes) - height and degeneration of the lumbar intervertebral disc(s), imaging exam; and S (study) - cross-sectional and case control. RESULTS: The risk of bias was in its moderate totality in its outcome: height and degeneration of the lumbar intervertebral disc(s) - imaging. Of the four selected studies, three found a decrease in the height of the disc(s) in sitting posture. CONCLUSION: The individual data from the manuscripts suggest that the sitting posture causes a reduction in the height of the lumbar intervertebral disc. It was also concluded that there is a need for new primary studies with a more in-depth design and sample size.

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BACKGROUND: The sculpting craft must adopt awkward postures that lead to musculoskeletal disorders (MSDs). OBJECTIVE: This study investigated the prevalence of musculoskeletal discomfort (MD) and its associations with postural risk factors, demographics, and work characteristics among sculptors. They were determined the differences between MDs during the weeks of the study. METHODS: A longitudinal study was conducted; MD was investigated using the Cornell Musculoskeletal Discomfort Questionnaire (CMDQ). Posture was assessed using the Rapid Upper Limb Assessment method (RULA). Multivariate logistic regression (MLR) models analyzed associations with different factors. ANOVA was used to test for differences in MD prevalence. RESULTS: The analysis included 585 responses by body region. The prevalence of MD was high in the lower and upper limbs among sculptors (67.6%), with the lower back, upper arm, neck, and knees being the four most affected regions. Gender (female) (OR = 2.15), marital status (married) (OR = 1.80), health risk (obesity), the dual of a secondary job (OR = 1.94), job stress (OR = 2.10), duration of work (OR = 2.01), and difficulty keeping up with work (OR = 2.00) were significant predictors contributing to the occurrence of MD in different body regions. Only shoulder MD prevalence showed significant differences between study weeks. CONCLUSIONS: Sculptors suffer from MD. Demographic and work characteristic factors influence MD prevalence. Postural training, improved adaptation of work organization, and intervention guidance on ergonomic risks may reduce the prevalence of MD and the risk of MSDs in this population.

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Introduction: Functional incapacity caused by physical alterations leads to significant limitations in daily activities and has a major impact on the return of people with disabilities to the social space and the workplace. This calls for an evaluation of the long-term influence of the use of a device specially developed for orthostatic posture on the physiological, biomechanical and functional parameters of amputees and spinal cord patients. Objective: The objective was evaluate the effect of postural support device use on function, pain, and biomechanical and cardiologic parameters in spinal cord injury and amputees patients compared to a control group. Methods: The orthostatic device was used by the participants for a period of ten consecutive days, for three cycles of 50 minutes each day, and a 15-day follow-up. Participants were positioned and stabilized using adjustable straps on the shoulders, trunk, and hips. The primary outcome was brief pain inventory. Fifteen participants were included the control group, 15 in the amputee group, and 15 in the spinal cord group. Results: Our results demonstrate that the use of the device allows the orthostatic position of amputees and spinal cord patients evaluated for ten days, leading to improved functionality and pain in the spinal cord and amputee groups compared to the control group. In addition, no changes were observed for secondary outcomes, indicating that the use of the device did not cause harm interference to patients. Conclusion: The long-term use of the orthostatic device is beneficial for improving functionality, reduce pain in amputees and spinal cord injury patients. Level of evidence II; Therapeutic Studies - Investigating the results of treatment.

Introdução: A incapacidade funcional causada por alterações físicas leva a limitações significativas nas atividades diárias e gera um grande impacto no retorno das pessoas com deficiência ao espaço social e ao local de trabalho, demandando a avaliação da influência em longo prazo do uso de um dispositivo especialmente desenvolvido para a postura ortostática nos parâmetros fisiológicos, biomecânicos e funcionais de pacientes amputados e com medula espinhal. Objetivo: O objetivo foi avaliar o efeito do uso do dispositivo de suporte postural na função, dor e parâmetros biomecânicos e cardiológicos em pacientes com lesão medular e amputados em comparação com um grupo controle. Métodos: O aparelho ortostático foi utilizado pelos participantes por um período de dez dias consecutivos, em três ciclos de 50 minutos diários, com acompanhamento de 15 dias. Os participantes foram posicionados e estabilizados por meio de alças ajustáveis nos ombros, tronco e quadris. O desfecho primário foi o questionário Breve Inventário de Dor. Quinze participantes foram incluídos no grupo controle, 15 no grupo amputado e 15 no grupo medular. Resultados: Nossos resultados demonstram que o uso do dispositivo permite a posição ortostática de amputados e pacientes com lesão medular avaliados por dez dias, levando a melhora da funcionalidade e dor nos grupos de amputados e medula espinhal em relação ao grupo controle. Além disso, não foram observadas alterações nos resultados secundários, indicando que o uso do dispositivo não causou interferência prejudicial aos pacientes. Conclusão: O uso prolongado do dispositivo ortostático é benéfico para melhorar a funcionalidade, reduzir a dor em amputados e pacientes com lesão medular. Nível de Evidência II; Estudos Terapêuticos - Investigação dos resultados de tratamento.

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Objective: Evaluate and correlate the sagittal balance parameters with the postural of the pelvis and lumbar spine. Methods: 80 individuals of both sexes, aged between 20 and 35 years, were evaluated. Biophotogrammetry was done with the SAPO software program. Measurements of the sagittal balance parameters were obtained by analyzing a lateral view panoramic radiography of the vertebral column, in which the anatomical points of reference were digitally marked. The calculation of the angles was done automatically by the Keops program. Results: In Keops assessment, 17.5% of the sample had high pelvic incidence angles (> 60°), 31.5% had low pelvic incidence angles (< 45°), and 51.2% had medium pelvic incidence angles (between 46° and 59°). SAPO showed 12,5% lordosis, 40% retroversion, and 47,5% normal curvature. In the right lateral view, pelvic incidence angle had a moderate and positive correlation with vertical alignment of the trunk and with vertical alignment of the body, and a negative and moderate correlation with horizontal alignment of the pelvis. Conclusion: Differences were found between vertical alignment measurements from the postural evaluation system (SAPO). A positive correlation was found between PI from Keops and pelvic anteversion from SAPO. Level of Evidence II; Prospective Study.

Objetivo: Avaliar e correlacionar o equilíbrio sagital com parâmetros posturais da pelve e coluna lombar. Métodos: Foram avaliados 80 indivíduos de ambos os sexos, com idade entre 20 e 35 anos. A biofotogrametria foi realizada com o software SAPO. As medidas dos parâmetros do equilíbrio sagital foram obtidas pela análise de uma radiografia panorâmica em perfil da coluna vertebral, na qual os pontos anatômicos de referência foram marcados digitalmente. O cálculo dos ângulos foi feito automaticamente pelo programa Keops. Resultados: Na avaliação Keops, 17,5% da amostra apresentavam ângulos de incidência pélvicos altos (> 60°), 31,5% tinham ângulos de incidência pélvicos baixos (< 45°) e 51,2% apresentavam ângulos de incidência pélvicos médios (entre 46° e 59°). O SAPO apresentou 12,5% de lordose, 40% de retroversão e 47,5% de curvatura normal. Na vista lateral direita, o ângulo de incidência da pelve apresentou correlação moderada e positiva com o alinhamento vertical do tronco e com o alinhamento vertical do corpo e negativa e moderada com o alinhamento horizontal da pelve. Conclusão: Foram encontradas diferenças entre as medidas de alinhamento vertical do sistema de avaliação postural (SAPO). Uma correlação positiva foi encontrada entre IP de Keops e anteversão pélvica de SAPO. Nível de Evidência II; Estudo Prospectivo.

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PURPOSE: To develop a questionnaire for adolescent idiopathic scoliosis (AIS) patients undergoing physiotherapeutic scoliosis-specific exercises (PSSE) and to evaluate its content validity, structural validity, and reliability. METHODOLOGY: Seven PSSE treatment experts checked the content validity of the Patient's Perception of Scoliosis-Specific Physiotherapy Questionnaire (Physio-IS). For each Physio-IS item, the content validity indexes must be ≥ 90%. Regarding structural validity and reliability 52 adolescents (ages 10-17) with AIS completed the questionnaire. Structural validity was assessed through exploratory factor analysis. Reliability was verified through internal consistency. RESULTS: Physio-IS content was validated in three evaluation rounds, obtaining 100% expert agreement. About structural validity we identified four domains (cumulative explained variance = 68.2%): (1) specific knowledge (seven questions on understanding their scoliosis condition); (2) social repercussion (five questions about social relationship implications); (3) pain (two questions about scoliosis-associated pain); and (4) associated concern (apprehension/expectations regarding the future). The Physio-IS demonstrated very good internal consistency (Cronbach's alpha = 0.76-0.92). CONCLUSION: The Physio-IS is a valid and reliable tool for assessing AIS patients undergoing PSSE and helping physiotherapists identify aspects requiring more attention, thus facilitating intervention strategies, as knowing the patient's perception of their condition or treatment is fundamental to AIS treatment success.

Physio-IS is an innovative tool in the treatment of Adolescent idiopathic scoliosis (AIS).Physio-IS is a valid and reliable tool for the assessment of adolescents with AIS undergoing phyisiotherapeutic scoliosis-specific exercises (PSSE).The specific questionnaire can contribute to physiotherapeutic treatment decisions, allowing the physical therapist to see the patient as a whole.

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BACKGROUND: The minimal important difference (MID) of the Postural Assessment Scale for Stroke Patients (PASS) remains unknown, limiting the interpretation of change scores. OBJECTIVES: To estimate the MID of the PASS in patients with subacute stroke. METHODS: Data at admission and discharge for 240 participants were retrieved from a longitudinal study. The "mobility" item of the Barthel Index was used as the anchor for indicating the improvement of posture control. Receiver operating characteristic (ROC) method was used to estimate the anchor-based MID of the PASS. RESULTS: The ROC method identified a MID of 3.0 points, with a sensitivity of 81.0 % and a specificity of 75.6 %. CONCLUSION: The MID of the PASS was 3.0 points, indicating that if a patient achieves an improvement of 3.0 or more points on the PASS, they have a clinically important improvement in posture control. Our results can help in interpreting change scores and aid in understanding the clinical values of treatment outcomes.

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Gait and balance difficulties pose significant clinical challenges in Parkinson's disease (PD). The impairment of physiological mechanisms responsible for maintaining natural orthostatism plays a central role in the pathophysiology of postural instability observed in PD. In addition to the well-known rigidity and abnormalities in muscles and joints, various brain regions involved in the regulation of posture, balance, and gait, such as the basal ganglia, cerebellum, and brainstem regions like the pontine peduncle nucleus, are affected in individuals with PD. The recognition of the cerebellum's role in PD has been increasingly acknowledged. Cortical areas and their connections are associated with freezing of gait, a type of frontal lobe ataxia commonly observed in PD. Furthermore, impairments in the peripheral nervous system, including those caused by levodopatherapy, can contribute to gait impairment and imbalance in PD patients. Consequently, individuals with PD may exhibit frontal ataxia, sensory ataxia, and even cerebellar ataxia as underlying causes of gait disturbances and imbalance, starting from the early stages of the disease. The complex interplay between dysfunctional brain regions, impaired cortical connections, and peripheral nervous system abnormalities contributes to the multifaceted nature of gait and balance difficulties in PD. Understanding the intricate mechanisms is crucial for the development of effective therapeutic approaches targeting these specific deficits in PD.

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Abstract Introduction The smartphone, a popular mobile device, has become attractive because it is easy to use and due to it multifunctionality. Its prolonged use, with anterior flexion of the neck and repetitive movements of the upper limbs, contributes to musculoskeletal symptoms. Objective To evaluate changes in cervical posture due to smartphone use in adults, as well as verify the association of posture with health-related factors. Methods Cross-sectional study, carried out at two universities in Fortaleza, Ceará, Brasil, between 2018 and 2019. A total of 769 adults (>18 years old) who routinely used smartphones participated. Data on socioeconomic variables, health conditions and smartphone use were collected. The cervical postural alignment was assessed, with the vertical head alignment (VHA) being measured using photogrammetry, in the anatomical position (baseline) and while typing on the smartphone. Results The mean age was 23 years (± 6.7), with a higher proportion of females (72.1%; n = 559) and an average of 7.9h (± 4.4) using the device. Smartphone use led to the forward head movement related to males (p < 0.05 by ΔVHA), time spent using the device (p < 0.05 by ΔVHA), functional disability in the cervical region (p < 0.05 by ΔVHA) and not sleeping well (p = 0.019 by ΔVHA on the R side). Conclusion Using a smartphone in the typing position causes the head to tilt forward, being related to longer usage time, male gender, cervical region dysfunction and sleep.

Resumo Introdução O smartphone, dispositivo móvel e popular, tornou-se atrativo pela facilidade de utilização e multifuncionalidade. Seu uso prolongado, com flexão anterior do pescoço e movimentos repetitivos dos membros superiores, contribui para sintomas musculoesqueléticos. Objetivo Avaliar as alterações da postura cervical pelo uso do smartphone em adultos, bem como verificar a associação da postura com fatores relacionados à saúde. Métodos Estudo transversal, em duas universidades em Fortaleza, Ceará, Brasil, entre 2018 e 2019. Participaram 769 adultos (>18 anos) que usavam rotineiramente o smartphone. Foram coletadas variáveis socioeconômicas, condições de saúde e uso do smartphone. Realizou-se a avaliação do alinhamento postural da cervical, sendo mensurado o alinhamento vertical da cabeça (AVC) pela fotogrametria, na posição anatômica (baseline) e digitando no smartphone. Resultados A idade média foi de 23 anos (± 6,7), com maior proporção do sexo feminino (72,1 %; n = 559) e média de 7,9h (± 4,4) utilizando o dispositivo. O uso do smartphone gerou anteriorização de cabeça relacionada ao sexo masculino (p < 0,05 pelo ΔAVC), tempo de uso do dispositivo (p < 0,05 pela ΔAVC), incapacidade funcional na região cervical (p < 0,05 pela ΔAVC) e não dormir bem (p = 0,019 pela ΔAVC lado D). Conclusão O uso do smartphone na posição de digitação causa anteriorização de cabeça, estando relacionado ao maior tempo de uso, ao sexo masculino, à disfunção da região cervical e ao sono.

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ABSTRACT - This study aimed to evaluate the relation between the postural pattern according to the Godelieve Denys-Struyf (GDS) method with postpartum depression and pain in immediate postpartum women. A cross-sectional study was conducted, including 29 women at 1-3 postpartum days. The Edinburgh Postnatal Depression Scale (EPDS) assessed depression and Visual Numerical Scale assessed pain score (from 0=no pain to 10=the most intense pain). Postural pattern was categorized into groups according to the deviation plane: axial (anteromedial, posteromedial, anteroposterior, and posteroanterior postures) and relational (anterolateral and posterolateral postures) or mixed, considering upper and lower limbs. Participants' age ranged from 19 to 41 years, body mass index from 21.4 to 43.8 kg/m 2 . The EPDS scored from 10 to 26 points. In total, 52% women reported pain, but the pain score was similar among postural pattern groups (p=0.77) and not correlated with EPDS (p=0.88). Women's postural patterns were: mixed (45%), relational (38%), and axial (17%). EPDS score was higher for relational pattern group than axial group (20.45±1.63 vs 15.00±3.24; p=0.01). In conclusion, the mixed postural pattern was the most frequent. The relational postural pattern group (anterolateral and posterolateral posture) presented a higher depression score than the axial postural pattern group. No association was found between postural patterns and the pain score or between pain and postpartum depression.

RESUMEN - El objetivo de este estudio fue evaluar la relación entre el patrón postural según el método Godelieve Denys-Struyf (GDS), la depresión postparto y el dolor en mujeres en el puerperio inmediato. Se realizó un estudio transversal con 29 mujeres en el período entre 1 y 3 días después del parto. Se evaluaron la depresión mediante la Escala de Depresión Postparto de Edimburgo (EPDS) y el dolor mediante la Escala Numérica Visual del Dolor (0=ningún dolor, 10=dolor intenso). El patrón postural se categorizó según el plano de la alteración postural: axial (planos anteromedial, posteromedial, anteroposterior y posteroanterior), relacional (planos anterolateral y posterolateral) o mixto considerando tanto las extremidades superiores como las inferiores. Los resultados mostraron que las mujeres, de entre 19 y 41 años de edad, tenían un índice de masa corporal entre 21,4 y 43,8 kg/m2. La puntuación de la EPDS osciló entre 10 y 26 puntos. El 52% de las mujeres declararon sentir dolor, pero la puntuación en la escala de dolor fue similar en los tres grupos de patrones posturales (p=0,77) y no hubo correlación con la puntuación de la EPDS (p=0,88). Los patrones posturales presentados fueron mixto (45%), relacional (38%) y axial (17%). La puntuación de la EPDS fue mayor en el grupo de patrón postural relacional en comparación con el axial (20,45±1,63 vs. 15,00±3,24; p=0,01). Se concluye que el patrón postural mixto fue el más frecuente entre las mujeres. El grupo con un patrón postural relacional (planos anterolateral y posterolateral) obtuvo mayores tasas en la EPDS que el axial. No hubo asociación entre el patrón postural y la puntuación en la escala de dolor ni entre el dolor y la depresión.

RESUMO - O objetivo deste estudo foi avaliar a relação entre o padrão postural, de acordo com o método Godelieve Denys-Struyf (GDS), a depressão pós-parto e a dor em mulheres no puerpério imediato. Foi realizado um estudo transversal com 29 mulheres no período de 1 a 3 dias após o parto. A depressão foi avaliada por meio da Escala de Depressão Pós-parto de Edimburgo (EPDS) e a dor pela Escala Visual Numérica de dor (0=ausência de dor, 10=pior dor possível). O padrão postural foi categorizado de acordo com o plano do desvio da postura: axial (posturas ântero-medial, póstero-medial, ântero-posterior e póstero-anterior), relacional (posturas ântero-lateral e póstero-lateral) ou misto, considerando membros superiores e inferiores. Como resultados, as mulheres, entre 19 e 41 anos de idade, apresentaram índice de massa corporal entre 21,4 e 43,8 kg/m 2 . A pontuação na EPDS variou de 10 a 26 pontos. 52% das mulheres relataram sentir dor, porém a pontuação na escala de dor foi similar nos três grupos de padrão postural (p=0,77) e não houve correlação com a pontuação na EPDS (p=0,88). Os padrões posturais apresentados foram: misto (45%), relacional (38%) e axial (17%). A pontuação da EPDS foi maior para o grupo de padrão postural relacional, em comparação com o axial (20,45±1,63 vs 15,00±3,24; p=0,01). Como conclusão, o padrão postural misto foi o mais frequente entre as mulheres. O grupo com padrão postural relacional (posturas ântero-lateral e póstero-lateral) apresentou maior pontuação na EPDS que o axial. Não houve associação entre o padrão postural e a pontuação na escala de dor ou entre a dor e a depressão.

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ABSTRACT Objective: To evaluate smartphone addiction and postural alterations in the cervical region in adolescents. Methods: A cross-sectional study with 281 adolescents (15 to 19 years old), attending the 1st to the 3rd grades of High School, carried out between September and October 2019 in the city of Fortaleza, Ceará, Brazil. Data collection took place in two stages. In the first, they answered four self-administered questionnaires: sociodemographic questionnaire, health conditions and smartphone use, Nordic Musculoskeletal Symptom Questionnaire (NMQ), Self-Report Questionnaire (SRQ-20) and the Smartphone Addiction Inventory (SPAI-BR). In the second stage, they were submitted to photogrammetry using the Postural Assessment Software (SAPO) and anthropometric assessment (weight and height). The software SPSS Statistics version 23.0 was used for data analysis. Results: Of the total number of adolescents, 63.3% (n=178) showed smartphone addiction, using it for 5.8 hours (±3.5) during the week and 8.7 (±4.0) hours on the weekend. When analyzing postural alignment in the anterior view, a significant reduction in the lateral head tilt was observed when typing on the smartphone (p=0.002) compared to the anatomical position (baseline). In the lateral view, an increase in head anteriorization was observed during smartphone use (p<0.05). There was an association between smartphone addiction and head anteriorization (p<0.05). Conclusions: The use of the smartphone in the typing position causes postural alterations in the cervical region, especially in adolescents with smartphone addiction. Therefore, health promotion measures that alert adolescents to the adverse effects caused by prolonged smartphone use are necessary.

RESUMO Objetivo: Avaliar a dependência do smartphone e a alteração postural da região cervical em adolescentes. Métodos: Estudo transversal, com 281 adolescentes (15 a 19 anos), que frequentavam da 1ᵃ à 3ᵃ série do ensino médio, realizado entre setembro e outubro de 2019 na cidade de Fortaleza, Ceará, Brasil. A coleta dos dados ocorreu em duas etapas. Na primeira, eles responderam a quatro questionários autoaplicáveis: questionário sociodemográfico, condições de saúde e uso do smartphon e, Questionário Nórdico de Sintomas Musculoesqueléticos (NMQ), Self-Report Questi onnaire (SRQ-20) e o Smartphone A ddiction Inventory (SPAI-BR). Na segunda etapa, foram submetidos a fotogrametria pelo Software de Avaliação Postural (SAPO) e avaliação antropométrica (peso e altura). Para a análise dos dados, foi utilizado o SPSS Statistics versão 23.0. Resultados: Do total, 63,3% (n=178) dos adolescentes apresentaram dependência do smartphone, com o uso de 5,8 horas (±3,5) durante a semana e 8,7 (±4,0) no fim de semana. Ao analisar o alinhamento postural na visão anterior, observou-se redução significativa da inclinação lateral de cabeça ao digitar no smartphon e (p=0,002) comparado à posição anatômica (baseline). Na visão lateral foi constatado aumento da anteriorização de cabeça durante o uso do smartphon e (p<0,05). Houve associação da dependência do smartphone com a anteriorização de cabeça (p<0,05). Conclusões: O uso do smartphone na posição de digitação causa alteração postural na região cervical, destacadamente naqueles que apresentam dependência do dispositivo. Dessa forma, são necessárias medidas de promoção de saúde que alertem os adolescentes sobre os efeitos adversos causados pelo uso prolongado do smartphone.

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ABSTRACT Objective: Evaluate and correlate the sagittal balance parameters with the postural of the pelvis and lumbar spine. Methods: 80 individuals of both sexes, aged between 20 and 35 years, were evaluated. Biophotogrammetry was done with the SAPO software program. Measurements of the sagittal balance parameters were obtained by analyzing a lateral view panoramic radiography of the vertebral column, in which the anatomical points of reference were digitally marked. The calculation of the angles was done automatically by the Keops program. Results: In Keops assessment, 17.5% of the sample had high pelvic incidence angles (> 60°), 31.5% had low pelvic incidence angles (< 45°), and 51.2% had medium pelvic incidence angles (between 46° and 59°). SAPO showed 12,5% lordosis, 40% retroversion, and 47,5% normal curvature. In the right lateral view, pelvic incidence angle had a moderate and positive correlation with vertical alignment of the trunk and with vertical alignment of the body, and a negative and moderate correlation with horizontal alignment of the pelvis. Conclusion: Differences were found between vertical alignment measurements from the postural evaluation system (SAPO). A positive correlation was found between PI from Keops and pelvic anteversion from SAPO. Level of Evidence II; Prospective Study.

RESUMO Objetivo: Avaliar e correlacionar o equilíbrio sagital com parâmetros posturais da pelve e coluna lombar Métodos: Foram avaliados 80 indivíduos de ambos os sexos, com idade entre 20 e 35 anos. A biofotogrametria foi realizada com o software SAPO. As medidas dos parâmetros do equilíbrio sagital foram obtidas pela análise de uma radiografia panorâmica em perfil da coluna vertebral, na qual os pontos anatômicos de referência foram marcados digitalmente. O cálculo dos ângulos foi feito automaticamente pelo programa Keops. Resultados: Na avaliação Keops, 17,5% da amostra apresentavam ângulos de incidência pélvicos altos (> 60°), 31,5% tinham ângulos de incidência pélvicos baixos (< 45°) e 51,2% apresentavam ângulos de incidência pélvicos médios (entre 46° e 59°). O SAPO apresentou 12,5% de lordose, 40% de retroversão e 47,5% de curvatura normal. Na vista lateral direita, o ângulo de incidência da pelve apresentou correlação moderada e positiva com o alinhamento vertical do tronco e com o alinhamento vertical do corpo e negativa e moderada com o alinhamento horizontal da pelve. Conclusão: Foram encontradas diferenças entre as medidas de alinhamento vertical do sistema de avaliação postural (SAPO). Uma correlação positiva foi encontrada entre IP de Keops e anteversão pélvica de SAPO. Nível de Evidência II; Estudo Prospectivo.

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ABSTRACT Introduction: Functional incapacity caused by physical alterations leads to significant limitations in daily activities and has a major impact on the return of people with disabilities to the social space and the workplace. This calls for an evaluation of the long-term influence of the use of a device specially developed for orthostatic posture on the physiological, biomechanical and functional parameters of amputees and spinal cord patients. Objective: The objective was evaluate the effect of postural support device use on function, pain, and biomechanical and cardiologic parameters in spinal cord injury and amputees patients compared to a control group. Methods: The orthostatic device was used by the participants for a period of ten consecutive days, for three cycles of 50 minutes each day, and a 15-day follow-up. Participants were positioned and stabilized using adjustable straps on the shoulders, trunk, and hips. The primary outcome was brief pain inventory. Fifteen participants were included the control group, 15 in the amputee group, and 15 in the spinal cord group. Results: Our results demonstrate that the use of the device allows the orthostatic position of amputees and spinal cord patients evaluated for ten days, leading to improved functionality and pain in the spinal cord and amputee groups compared to the control group. In addition, no changes were observed for secondary outcomes, indicating that the use of the device did not cause harm interference to patients. Conclusion: The long-term use of the orthostatic device is beneficial for improving functionality, reduce pain in amputees and spinal cord injury patients. Level of evidence II; Therapeutic Studies - Investigating the results of treatment.

RESUMO Introdução: A incapacidade funcional causada por alterações físicas leva a limitações significativas nas atividades diárias e gera um grande impacto no retorno das pessoas com deficiência ao espaço social e ao local de trabalho, demandando a avaliação da influência em longo prazo do uso de um dispositivo especialmente desenvolvido para a postura ortostática nos parâmetros fisiológicos, biomecânicos e funcionais de pacientes amputados e com medula espinhal. Objetivo: O objetivo foi avaliar o efeito do uso do dispositivo de suporte postural na função, dor e parâmetros biomecânicos e cardiológicos em pacientes com lesão medular e amputados em comparação com um grupo controle. Métodos: O aparelho ortostático foi utilizado pelos participantes por um período de dez dias consecutivos, em três ciclos de 50 minutos diários, com acompanhamento de 15 dias. Os participantes foram posicionados e estabilizados por meio de alças ajustáveis nos ombros, tronco e quadris. O desfecho primário foi o questionário Breve Inventário de Dor. Quinze participantes foram incluídos no grupo controle, 15 no grupo amputado e 15 no grupo medular. Resultados: Nossos resultados demonstram que o uso do dispositivo permite a posição ortostática de amputados e pacientes com lesão medular avaliados por dez dias, levando a melhora da funcionalidade e dor nos grupos de amputados e medula espinhal em relação ao grupo controle. Além disso, não foram observadas alterações nos resultados secundários, indicando que o uso do dispositivo não causou interferência prejudicial aos pacientes. Conclusão: O uso prolongado do dispositivo ortostático é benéfico para melhorar a funcionalidade, reduzir a dor em amputados e pacientes com lesão medular. Nível de Evidência II; Estudos Terapêuticos - Investigação dos resultados de tratamento.

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We investigated postural stability through the margin of stability (MoS) while reaching and grasping an object with increasing difficulty levels in younger, fallers and non-fallers. Forty-five individuals distributed into three groups participated in this study: younger adults (YA), non-fallers (OA), and fallers (FOA). They stood upright and reached and grasped a dowel. Six conditions combining the stability of the dowel's base and obstacles close to the dowel were manipulated to characterize different difficulty levels. We computed the MoS in both anterior-posterior (AP) and medial-lateral (ML) directions in the interval between reaching onset and dowel contact. From the MoS time series, we analyzed the minimum and maximum, including the time of occurrence of these events. The MoS was smaller for OA than for YA in both directions. In the ML direction, the minimum MoS was smaller for FOA than for YA. The minimum MoS took place earlier for FOA than YA in the AP direction. FOA and OA exhibited similar behavior with reduced MoS, suggesting impaired postural control during reaching-to-grasping in a standing posture. FOA used a more cautious strategy by reverting the MoS earlier than YA, allowing them to increase their MoS before YA when preparing to grasp the dowel.

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La postura corporal es el resultado de la compleja interacción del sistema músculo-esquelético y nervioso que permite al cuerpo mantenerse en una posición adecuada, con un balance ergonómico y un gasto de energía mínimo. Las exigencias técnicas y el perfil morfofuncional del polista se complementan como factores internos predisponentes a lesiones por sobreuso. El objetivo del estudio consistió en analizar el perfil postural en jugadores élite de polo acuático. Se diseñó un estudio descriptivo, prospectivo y transversal. Los métodos científicos seleccionados estuvieron en el nivel teórico, empírico y estadístico-matemático. Se evaluaron 18 polistas masculinos, de élite, de 18 a 33 años de edad. En el plano frontal, el perfil predominante fue cabeza centrada (13; 72,2 %), con hombro izquierdo más alto (14; 77,8 %), espina iliaca anterosuperior homolateral más alta (10; 55,6 %), triángulo torácico derecho más grande que el izquierdo (10; 55,6%) y ambas rodillas con correcta alineación frontal (10; 55,6 %). En el plano sagital la cabeza se observó adelantada (18; 100 %), pelvis neutra (14; 77,78 %), ambas rodillas en recurvatum (10; 55,6 %) e inclinación corporal anterior (18; 100 %) con un rango de angulación de 2-6 grados. En el plano frontal posterior la cabeza se encontró neutra (14; 77,78 %) con inclinación corporal izquierda (12; 66,67 %). La evaluación del perfil de postura en polistas es útil para diagnosticar desalineaciones en los segmentos corporales, al generar una herramienta en el control biomédico del entrenamiento deportivo.

A postura corporal é resultado da complexa interação do sistema musculoesquelético e nervoso que permite ao corpo permanecer em uma posição adequada, com equilíbrio ergonômico e mínimo gasto energético. As exigências técnicas e o perfil morfofuncional do jogador de pólo complementam-se como fatores internos predisponentes a lesões por uso excessivo. O objetivo do estudo foi analisar o perfil postural em jogadores de elite de pólo aquático. Foi desenhado um estudo descritivo, prospectivo e transversal. Os métodos científicos selecionados foram de nível teórico, empírico e estatístico-matemático. Foram avaliados 18 jogadores de pólo de elite do sexo masculino, com idades entre 18 e 33 anos. No plano frontal, o perfil predominante foi cabeça centrada (13; 72,2%), com ombro esquerdo mais alto (14; 77,8%), espinha ilíaca ântero-superior ipsilateral mais alta (10; 55,6%), triângulo torácico direito maior que o esquerdo ( 10; 55,6%) e ambos os joelhos com alinhamento frontal correto (10; 55,6%). No plano sagital observou-se cabeça para frente (18; 100%), pelve neutra (14; 77,78%), ambos os joelhos em recurvatum (10; 55,6%) e inclinação anterior do corpo (18; 100%) com amplitude de angulação de 2-6 graus. No plano frontal posterior a cabeça estava neutra (14; 77,78 %) com inclinação do corpo para a esquerda (12; 66,67 %). A avaliação do perfil postural em jogadores de pólo é útil para diagnosticar desalinhamentos em segmentos corporais, gerando uma ferramenta no controle biomédico do treinamento esportivo.

Body posture is the result of the complex interaction of the musculoskeletal and nervous system that allows the body to remain in an adequate position, with ergonomic balance and minimal energy expenditure. The technical demands and the morphofunctional profile of the polo player complement each other as internal factors predisposing to injuries due to overuse. The objective of the study was to analyze the postural profile in elite water polo players. A descriptive, prospective and cross-sectional study was designed. The selected scientific methods were at the theoretical, empirical and statistical-mathematical level. 18 elite male polo players, aged 18 to 33, were evaluated. In the frontal plane, the predominant profile was centered head (13; 72.2 %), with higher left shoulder (14; 77.8 %), higher ipsilateral anterior superior iliac spine (10; 55.6 %), triangle right thoracic larger than the left (10; 55.6 %) and both knees with correct frontal alignment (10; 55.6 %). In the sagittal plane, the head was observed forward (18; 100 %), neutral pelvis (14; 77.78 %), both knees in recurvatum (10; 55.6 %) and anterior body inclination (18; 100 %) with an angulation range of 2-6 degrees. In the posterior frontal plane, the head was neutral (14; 77.78 %) with left body inclination (12; 66.67 %). The evaluation of the posture profile in polo players is useful to diagnose misalignments in body segments, generating a tool in the biomedical control of sports training.

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Construir e validar um questionário para avaliar a autopercepção de professores sobre sua postura e a percepção dos hábitos posturais dos alunos em diferentes situações no ambiente escolar. Foram realizadas 7 etapas para a construção do questionário. A estratégia de validação de conteúdo foi julgada por um painel de especialistas e pelo Índice de Validade (VI). A confiabilidade teste-reteste foi realizada com professores e medida pelo Coeficiente de Correlação Intraclasse (ICC) e Coeficiente Kappa (KC). 11 especialistas com doutorado, experiência em educação e na área de postura participaram da validação de conteúdo e 40 professores participaram da confiabilidade teste-reteste. As medidas de VI foram todas acima de 0,81, e a média geral de ICC e KC foi de 0,94 e 0,91, respectivamente. Este questionário foi considerado válido, confiável e viável com linguagem compreensível para os professores. Pode ser recomendado para pesquisas em escolas e programas de educação postural, contribuindo para a prevenção de hábitos posturais inadequados e suas consequências.

To construct and validate a questionnaire for assessing teachers' self-perception of their posture, and their perception of students' posture habits in different situations in the school environment. 7-step were performed for the construction of the questionnaire. The content validation strategy was judged by a panel of experts and the Validity Index (VI). Test-retest reliability was performed with teachers and measured by the Intraclass Correlation Coefficient (ICC) and Kappa Coefficient (KC). Eleven experts with a doctorate, experience in education, and the field of posture participated in content validation and 40 teachers participated in test-retest reliability. VI measurements were all above 0.81, and the overall mean of ICC and KC were 0.94 and 0.91, respectively. This questionnaire was considered valid, reliable, and feasible with language understandable to teachers. It can be recommended for research in schools, and posture education programs, contributing to the prevention of inadequate posture habits and their consequences.

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BACKGROUND: Parkinson's disease (PD) is initially characterized by a rigid-akinetic syndrome and later by the development of postural instability. This condition often leads to balance impairments, potentially resulting in postural deformities and foot asymmetry. This study aimed to assess balance changes in PD patients. METHODS: We evaluated 56 PD patients and 30 controls using static posturography. The variables examined included foot type, the primary region of body weight distribution on the plantar surface, statokinesigram (center of pressure [COP]), and stabilogram (COP in the X- and Y-axes). RESULTS: PD patients exhibited a high prevalence of pes cavus (92.8%) (p < 0.001) and greater weight distribution toward the hindfoot. In all assessments, COP sway areas were significantly larger in PD patients (p < 0.001). The total COP area increased in the non-fall group during the foot parallel assessment and in the X-axis in the fall group with eyes open (p = 0.046) and closed (p = 0.023). Significant correlations between body weight discharge on the plantar area and COP sway were observed, particularly in the non-postural instability group in the COP X-axis with feet parallel and eyes open on the more rigid limb and in the postural instability group in the Y-axis with feet parallel and eyes open on the more rigid limb and with eyes closed bilaterally. CONCLUSION: Progressive rigidity may disrupt compensatory mechanisms, altering foot morphology, shifting body weight discharge posteriorly, and increasing COP sway. This cascade of events results in impaired balance and an elevated risk of falls.

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Incorrect postural habits developed already at an early age are predictors of low back pain and functional limitations in adult life. Postural education programs (PEPs) are activities developed in Physical Education classes with the aim of promoting healthy habits. One tool used by PEPs is comics. The objective of this study was to develop comics and apply them as a teaching tool in PEPs for students aged seven to ten years. The procedures were based on individual empowerment principles, including creation activities, reading, painting, crosswords, and discussion of comics. The activities strengthened the students' interactions, gaining new knowledge that required cognitive and expressive resources to interpret, associate, and conceptualize themes of correct body posture. During six weeks of intervention, knowledge about body posture, anatomy, and health promotion exercises increased significantly in relation to the beginning of activities. The comic book proved to be an effective, attractive, and low-cost didactic resource.

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BACKGROUND: In the last ten years, the design and implementation of Optical Fiber Sensors (OFS) in biomedical applications have been discussed, with a focus on different subareas, such as body parameter monitoring and control of assistive devices. MATERIALS AND METHODS: A scoping review was performed including scientific literature (PubMed/Scopus, IEEE and Web of Science), patents (WIPO/Google Scholar), and commercial information. RESULTS: The main applications of OFS in the rehabilitation field for preventing future postural diseases and applying them in device controllers were discussed in this review. Physical characteristics of OFS, different uses, and applications of Polymer Optical Fiber pressure sensors are mentioned. The main postures used for posture monitoring analysis when the user is sitting are normal position, crooked back, high lumbar pressure, sitting on the edge of the chair, and crooked back, left position, and right position. Additionally, it is possible to use Machine Learning (ML) algorithms for posture classification, and device control such as Support Vector Machine, k-Nearest Neighbors, etc., obtaining accuracies above 97%. Moreover, the literature mentions wheelchair controllers and Graphical User Interfaces using pressure maps to provide feedback to the user. CONCLUSIONS: OFS have been used in several healthcare applications as well as postural and preventive applications. The literature showed an effort to implement and design accessible devices for people with disabilities and people with specific diseases. Alternatively, ML algorithms are widely used in this direction, leaving the door open for further studies that allow the application of real-time systems for posture monitoring and wheelchairs control.

IMPLICATIONS FOR REHABILITATIONPosture monitoring and ulcer detection systems are very useful to prevent or treat diseases related to bedsores or pressure ulcers using a different kind of electronic or optic instrumentation to improve the user's quality of life.The system characteristics using optical fiber sensors discussed in this review set an important precedent in the fabrication of low-cost systems for biomedical applications.