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1.
J Bodyw Mov Ther ; 39: 237-242, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38876632

RESUMO

BACKGROUND: People with Parkinson's disease (PD) have impaired upper limb motor coordination, limiting the execution of activities of daily living. This study investigated the feasibility and safety of a short-term Pilates-based exercise program in the treatment of upper limb motor coordination for people with PD. METHODS: Fifteen patients - n (%) 4 women/11 men (27/73), median [interquartile range] age 66 [9] years - participated in this quasi-experimental (before-and-after) clinical trial. Patients underwent a 6-week (30 min/day, 3 days/week) Pilates exercise program using Reformer, Cadillac, Chair, and Barrel equipment. Feasibility was evaluated by adherence to the program and the ability to perform the exercises including progressions on difficulty. Safety was evaluated based on self-reported adverse events. Clinical and functional trends before and after the intervention were also computed regarding handgrip strength (HGS), fine motor coordination (9 Hole Peg Test; 9HPT), bradykinesia (Movement Disorder Society - Unified Parkinson's disease Rating Scale; MDS-UPDRS), and upper limb functionality (Test D'évaluation des Membres Supérieurs des Personnes Âgées, TEMPA). RESULTS: Of the 18 Pilates sessions, exercise adherence was 100%. The only adverse event observed was mild muscle pain. Pre-post differences were observed only for body bradykinesia and hypokinesia (1.0 [0.0] vs. 0.0 [1.0] s, adjusted p = 0.048). CONCLUSIONS: A short-term Pilates-based exercise program in the treatment of upper limb muscle strength, manual dexterity, bradykinesia, and functionality is feasible and safe for people with PD. Changes in upper limb bradykinesia encourage randomized clinical trials.


Assuntos
Técnicas de Exercício e de Movimento , Força da Mão , Doença de Parkinson , Extremidade Superior , Humanos , Feminino , Doença de Parkinson/reabilitação , Doença de Parkinson/fisiopatologia , Técnicas de Exercício e de Movimento/métodos , Masculino , Idoso , Extremidade Superior/fisiopatologia , Extremidade Superior/fisiologia , Pessoa de Meia-Idade , Força da Mão/fisiologia , Força Muscular/fisiologia , Atividades Cotidianas , Hipocinesia/reabilitação , Hipocinesia/fisiopatologia , Terapia por Exercício/métodos
2.
BrJP ; 6(2): 139-144, Apr.-June 2023. tab
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1513788

RESUMO

ABSTRACT BACKGROUND AND OBJECTIVES: Particular pain features, such as pain interference, neuropathic-like symptoms, and central sensitization (CS) symptoms may be present in patients with Chikungunya fever and lead to functional limitations. The present study aimed to assess the association between pain characteristics and the disability in participants affected by Chikungunya fever in the chronic phase. METHODS: A cross-sectional study was conducted with 36 participants who filled out a sociodemographic, pain characteristics (pain interference - Brief Pain Inventory, neuropathic-like symptoms - PainDETECT Questionnaire, and CS-related signs and symptoms - Central Sensitization Inventory) and disability (Health Assessment Questionnaire) questionnaires. The Spearman correlation test (rho) verified the relationship between the outcomes. RESULTS: Most of the participants were female (77%), with a mean age of 43 years. Twenty-seven (75%) participants presented nociceptive pain and 11 (30%) had central sensitization symptoms. There was a high positive correlation between the presence of neuropathic-like symptoms and disability (rho=0.71; p<0.001) and pain intensity and disability (rho=0.76; p<0.001). A moderate positive correlation was found between the central sensitization symptoms and disability (rho=0.51; p=0.002). Moreover, there is a low positive correlation between pain interference in an individual's life and disability (rho=0.34; p=0.041). CONCLUSION: Patients in chronic phase of Chikungunya fever revealed mild pain intensity and predominance of nociceptive pain. Pain interference, neuropathic-like symptoms, and central sensitization symptoms negatively impact individual's disability after Chikungunya fever.


RESUMO JUSTIFICATIVA E OBJETIVOS: Características particulares da dor, como interferência da dor, sintomas do tipo neuropático e sintomas de sensibilização central (SC), podem estar presentes em pacientes com febre Chicungunha e levar a limitações funcionais. O presente estudo teve como objetivo avaliar a correlação entre as características da dor e a capacidade funcional em participantes acometidos pela febre Chicungunha na fase crônica. MÉTODOS: Foi realizado um estudo transversal com 36 participantes que preencheram questionários sociodemográficos, de características de dor (interferência da dor - Inventário Breve de Dor, sintomas do tipo neuropático - questionário PainDETECT, e sinais e sintomas relacionados à SC - Inventário de Sensibilização Central) e de capacidade funcional (Health Assessment Questionnaire). O teste de correlação de Spearman (rho) verificou a relação entre os desfechos. RESULTADOS: A maioria dos participantes era do sexo feminino (77%), com média de idade de 43 anos. Vinte e sete (75%) participantes apresentaram dor nociceptiva e 11 (30%) apresentaram sintomas de sensibilização central. Houve alta correlação positiva entre a presença de sintomas do tipo neuropático e capacidade funcional (rho=0,71; p<0,001) e intensidade da dor e capacidade funcional (rho=0,76; p<0,001). Foi encontrada uma correlação positiva moderada entre os sintomas de sensibilização central e a capacidade funcional (rho=0,51; p=0,002). Além disso, há uma correlação positiva baixa entre a interferência da dor na vida do indivíduo e a capacidade funcional (rho=0,34; p=0,041). CONCLUSÃO: Pacientes em fase crônica da febre Chicungunha apresentaram intensidade de dor leve e predominância de dor nociceptiva. A interferência da dor, os sintomas do tipo neuropático e os sintomas de sensibilização central afetam negativamente a capacidade funcional do indivíduo após a febre Chicungunha.

3.
Geriatr Nurs ; 49: 109-114, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36495792

RESUMO

Falls in hospitalized older adults are of concern and, despite the availability of fall risk assessment methods and knowledge about factors associated with falls, their validity and agreement remain poorly investigated. In a prospective study, we enrolled 102 hospitalized older adults (median [P25-P75]) 67 (64-73) years, 52 [51%] men, length of stay 20 [8-41] days). Fall risk was assessed at hospital admission using the Functional Independence Measure; Morse Fall Scale; St. Thomas's Risk Assessment Tool in Falling Elderly Inpatients; Johns Hopkins Fall Risk Assessment Tool; and polypharmacy. The St. Thomas's Risk Assessment Tool in Falling Elderly Inpatients method showed the highest predictive performance (accuracy 92%) for the identification of fallers during hospitalization. A slightly better-then-chance agreement was estimated between all methods (Light's κ = 0.120). Fall risk assessment methods and factors associated with falls should not be used interchangeably as their overall and pairwise agreement are fair at best.


Assuntos
Hospitalização , Masculino , Humanos , Idoso , Feminino , Estudos Longitudinais , Estudos Prospectivos , Medição de Risco/métodos , Fatores de Risco
4.
Clin Biomech (Bristol, Avon) ; 97: 105711, 2022 07.
Artigo em Inglês | MEDLINE | ID: mdl-35779462

RESUMO

BACKGROUND: Postural instability with an excessive body sway is a disabling manifestation in spinocerebellar ataxia type 3. Whether the larger body sway reflects distinct movement strategies for postural control remains uncertain. This study compared the control of postural stability of people with spinocerebellar ataxia type 3 with healthy subjects using body sway and movement strategy analyses derived from bi- and three-dimensional posturography. METHODS: Twenty-three patients (7 men, 16 women, 47 ± 11 years) and 102 healthy participants (34 men, 68 women; 44 ± 22 years) underwent posturography while standing with eyes open/closed tasks. Postural stability was assessed using elliptical area and average velocity of body sway. Spatial patterns (single-, double-, or multi-centered) were derived from the number of high-density regions in the three-dimensional statokinesigram. FINDINGS: Repeated measures two-way analysis-of-variance showed a vision-by-group interaction effect for area (F1,122 = 28.831, P < 0.001, η2 = 0.037) and velocity (F1,123 = 59.367, P < 0.001, η2 = 0.073); sway area and velocity were higher in spinocerebellar ataxia type 3 and increased under eyes-closed condition, with a higher increase in the spinocerebellar ataxia type 3. A main effect for group (F1,123 = 11.702, P < 0.001, η2 = 0.061) but not vision (F1,123 = 2.257, P = 0.136, η2 = 0.005) was found for the number of high-density regions. Spatial patterns were different between groups under trials with eyes closed (χ22,125 = 7.46, P = 0.023) but not open (χ22,125 = 2.026, P = 0.363), with a shift from single- to double- or multi-centered spatial patterns. INTERPRETATION: Compared to healthy subjects, a larger body displacement and velocity in spinocerebellar ataxia type 3, mainly under visual constraints, are not related to the predominance of either ankle or hip movement strategies.


Assuntos
Doença de Machado-Joseph , Postura , Estudos Transversais , Feminino , Humanos , Masculino , Movimento , Equilíbrio Postural
5.
Fisioter. Pesqui. (Online) ; 27(2): 168-173, abr.-jun. 2020. tab, graf
Artigo em Português | LILACS-Express | LILACS | ID: biblio-1133925

RESUMO

RESUMO A assimetria na distribuição do peso corporal (DPC) é um achado comum após um acidente vascular cerebral. Embora a posturografia seja considerada o padrão-ouro para a detecção da assimetria da DPC, exige equipamentos e conhecimentos específicos, limitando seu uso na prática clínica. Por outro lado, a Escala de Avaliação da Simetria e Transferência de Peso (ASTP) é um método simples para identificar a assimetria na DPC. Entretanto, não foi testado se seus resultados estão relacionados às medidas posturográficas. Assim, o objetivo desse estudo foi avaliar a validade concorrente por meio da identificação do grau de associação entre a ASTP e as medidas posturográficas da DPC em indivíduos com hemiparesia. Sessenta indivíduos, com hemiparesia [mediana (min-max)] 58 (33-86) anos e 24 (6-29) meses desde o primeiro AVC, foram avaliados. zA DPC foi avaliada por meio da ASTP e da posturografia (percentual da DPC sobre o membro não parético). A mediana do escore ASTP foi 23 (14-27), "capacidade parcialmente boa de simetria e transferência de peso". A posturografia revelou 59% de apoio do peso corporal (50-97) sobre o lado não parético. Além disso, identificou uma proporção maior de indivíduos assimétricos do que a ASTP (29 vs. 8; p=0,003). Não houve correlação significativa entre ASTP e %DPC (rho=0,001, p=0,992). Concluiu-se que a ASTP não está relacionada à assimetria na DPC estimada pela posturografia, sugerindo a necessidade de uma reavaliação de sua utilidade clínica.


RESUMEN La asimetría en la distribución del peso corporal (DPC) es un hallazgo común tras el accidente cerebrovascular. Aunque se considera la posturografía el patrón de oro para la detección de asimetrías en la DPC, se requiere equipos y conocimientos específicos, lo que limita su uso en la práctica clínica. Por otro lado, la Escala de Evaluación de Simetría y Transferencia de Peso (ASTP) es un método sencillo para identificar la asimetría en la DPC. Sin embargo, no se ha comprobado si sus resultados están relacionados con las mediciones posturográficas. Así este estudio tuvo como objetivo evaluar la validez concurrente identificando el grado de asociación entre la ASTP y las mediciones posturográficas de la DPC en los individuos con hemiparesia. Se evaluaron a 60 individuos con hemiparesia [mediana (mín-máx)] 58 (33-86) años y 24 (6-29) meses desde el primer accidente cerebrovascular. La DPC se evaluó por medio de la ASTP y la posturografía (porcentaje de DPC en el miembro no parético). La puntuación media de la ASTP fue de 23 (14-27), "capacidad parcialmente buena de simetría y transferencia de peso". La posturografía reveló un 59% de apoyo del peso corporal (50-97) en el lado no parético. Además, identificó una mayor proporción de individuos asimétricos que la ASTP (29 vs. 8; p=0,003). No hubo una correlación significativa entre el ASTP y el %DPC (rho=0,001, p=0,992). Se concluyó que la ASTP no está relacionada con la asimetría en la DPC estimada por la posturografía, lo que sugiere la necesidad de reevaluar su utilidad clínica.


ABSTRACT Asymmetry in body weight distribution (BWD) is a common post-stroke finding. Although posturography is considered the gold standard for detection of BWD asymmetry, it requires specific equipment and knowledge, which limits its use in clinical practice. The Assessment of Symmetry and Weight-Transfer (ASWT) scale is a simpler method to identify asymmetry in body weight distribution. However, it has not been tested whether its scores are related to posturographic measures. Thus, the aim of this study was to evaluate concurrent validity by the association between ASWT and the posturographic measures of BWD in individuals with hemiparesis. Sixty hemiparetic patients [median (min-max)] 58 (33-86) years-old and with 24 (6-29) months after the first stroke were evaluated. The BWD was assessed through ASWT and BWD percentage over the non-paretic limb by posturography. The median ASWT score was 23 (14-27), "partially good capacity of symmetry and weight transfer". The posturography revealed 59% BWD (50-97), a significant asymmetry to the non-paretic side. Posturography identifies a higher proportion of asymmetric individuals than the ASWT (29 vs. 8, respectively; p=0.003). There was no significant correlation between ASWT and %BWD (ρ=0.001, p=0.992). We concluded that ASWT is not related to asymmetry in the BWD estimated by posturography, suggesting the need of a reassessment of its clinical utility.

6.
Pain Pract ; 19(7): 732-739, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31173663

RESUMO

BACKGROUND: Pain is a common symptom in Parkinson disease (PD). OBJECTIVES: To analyze the relationship between pain and motor dysfunction in individuals with PD. METHODS: Fifty-four individuals with PD were screened: Hoehn and Yahr scale score = 2.5 (1 to 4); median (range) age in the "on" period of anti-Parkinson medication was 66 (44 to 85) years. Pain was assessed using King's Parkinson's Disease Pain Scale (KPPS) and the Brief Pain Inventory (BPI). Performance in routine activities and motor function were assessed using Unified Parkinson Disease Rating Scale (UPDRS II and III); gait was assessed using the Dynamic Gait Index; and balance was assessed using the Mini-BESTest. RESULTS: Thirty-eight participants (70.3%) reported mild to moderate pain. A positive correlation was found between the total KPPS score and performance in general activities (UPDRS II) (rho = 0.29, P = 0.04); a negative correlation was found between pain intensity (BPI intensity) and motor function (UPDRS III; rho = -0.28, P = 0.04); and a negative correlation was found between pain intensity (BPI intensity) and the bradykinesia subscore of the UPDRS III (rho = -0.29, P = 0.04). There was no correlation between pain and gait performance or balance. The musculoskeletal pain was the predominant type (in 81.5% of subjects), followed by nocturnal pain (52.6%) and fluctuation-related pain (47.3%). The most painful areas were lower limbs (33.0%) and shoulders/cervical area (31.0%). Twenty-one of 38 participants (55.3%) reported pain interference in their working and walking ability and general activities. CONCLUSIONS: Pain was weakly correlated with performance in general activities and with bradykinesia but was not correlated with the remaining classic motor PD symptoms, either gait or balance performance. Pain was a prevalent symptom in the present sample, and the individuals reported its interference with functionality.


Assuntos
Transtornos Motores , Dor , Doença de Parkinson , Idoso , Estudos Transversais , Feminino , Marcha , Humanos , Masculino , Pessoa de Meia-Idade , Atividade Motora , Medição da Dor
7.
Rehabil Res Pract ; 2018: 7172686, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29535874

RESUMO

BACKGROUND AND PURPOSE: The motor impairments related to gait and balance have a huge impact on the life of individuals with spinocerebellar ataxia (SCA). Here, the aim was to assess the possibility of retraining gait, improving cardiopulmonary capacity, and challenging balance during gait in SCA using a partial body weight support (BWS) and a treadmill. Also, the effects of this training over functionality and quality of life were investigated. METHODS: Eight SCA patients were engaged in the first stage of the study that focused on gait training and cardiovascular conditioning. From those, five took part in a second stage of the study centered on dynamic balance training during gait. The first and second stages lasted 8 and 10 weeks, respectively, both comprising sessions of 50 min (2 times per week). RESULTS: The results showed that gait training using partial BWS significantly increased gait performance, treadmill inclination, duration of exercise, and cardiopulmonary capacity in individuals with SCA. After the second stage, balance improvements were also found. CONCLUSION: Combining gait training and challenging tasks to the postural control system in SCA individuals is viable, well tolerated by patients with SCA, and resulted in changes in capacity for walking and balance.

8.
Rev. dor ; 17(1): 29-33, Jan.-Mar. 2016. tab, graf
Artigo em Inglês | LILACS | ID: lil-776636

RESUMO

RESUMO JUSTIFICATIVA E OBJETIVOS: A dor é um grave problema mundial de saúde, tornando o gerenciamento dessa condição um desafio para os profissionais de saúde. O estudo da dor tem sido abordado de maneira superficial durante o processo de formação desses profissionais, refletindo-se em práticas clínicas ineficazes. O objetivo deste estudo foi avaliar o grau do conhecimento neurofisiológico da dor de estudantes de fisioterapia, após serem utilizadas estratégias ativas de ensino-aprendizagem na abordagem do tema. MÉTODOS: Foi conduzido um estudo experimental não controlado com 14 estudantes do quinto período do curso de Fisioterapia. Durante o período letivo, o aprendizado da neurofisiologia da dor foi baseado em estratégias ativas de ensino-aprendizagem, com foco problematizador e aplicação prática das possíveis soluções por parte dos estudantes. O Questionário Neurofisiológico da Dor foi utilizado para avaliar o conhecimento da neurofisiologia da dor, antes e após o curso da disciplina. RESULTADOS: Foi observada melhora significativa (p=0,002) do percentual de acertos no Questionário Neurofisiológico da Dor final da intervenção quando comprado à avaliação inicial. CONCLUSÃO: Os alunos de fisioterapia obtiveram melhora do conhecimento neurofisiológico da dor com a utilização de estratégias ativas de ensino-aprendizagem.


ABSTRACT BACKGROUND AND OBJECTIVES: Pain is a severe world health problem, making its management a challenge for health professionals. The study of pain has been superficially addressed during health professionals' qualification, reflecting in ineffective clinical practices. This study aimed at evaluating the level of neurophysiologic pain knowledge of physiotherapy students after using active teaching-learning strategies to address the subject. METHODS: This was an uncontrolled experimental study with 14 students of the fifth period of the Physiotherapy course. During the school year, pain neurophysiology teaching was based on active teaching-learning strategies, focused on problems and practical application of possible solutions by students. Neurophysiologic Pain Questionnaire was used to evaluate pain neurophysiology knowledge before and after the discipline. RESULTS: There has been significant improvement (p=0.002) in the number of right answers to the Neurophysiologic Pain Questionnaire at intervention completion as compared to baseline evaluation. CONCLUSION: Physiotherapy students have improved their knowledge about pain neurophysiology with the use of active teaching-learning strategies.

9.
Rev. bras. neurol ; 51(4): 100-105, out.-dez. 2015. tab
Artigo em Português | LILACS | ID: lil-774688

RESUMO

Na doença de Parkinson (DP), uma desordem neurológica complexa, ocorre depleção de dopamina por degeneração dos neurônios da substância negra, ocasionando perdas motoras e cognitivas. Os quatro principais sintomas que acometem indivíduos com DP são o tremor de repouso, a rigidez, a bradicinesia e a instabilidade postural. Essas alterações podem aumentar o risco de quedas e trazer prejuízos para as atividades e participação social dos indivíduos. O objetivo deste estudo é avaliar a funcionalidade, incapacidade e qualidade de vida dos pacientes com DP em atendimento fisioterapêutico em um hospital universitário no Rio de Janeiro. Os pacientes foram avaliados por meio dos seguintes instrumentos: escala de Hoehn e Yahr, questionário sobre a qualidade de vida na doença de Parkinson - PDQ-39 -, Miniexame do Estado Mental, Escala de Equilíbrio de Berg, teste de caminhada de 10 metros, timed up and go test, Dynamic Gait Index, Escala Unificada de Avaliação para a Doença de Parkinson e Escala de Schwab e England. Embora a maior parte dos indivíduos estivesse no estágio 3 de Hoehn e Yahr, a maioria apresentou risco de queda diminuído, bom estado cognitivo e emocional, qualidade de vida moderada e pouca dificuldade para a marcha e realização de atividades de vida diária (AVD). Os dados obtidos com este estudo servirão para a orientação da implementação de medidas fisioterapêuticas voltadas para essa amostra de pacientes, orientações de gestores para uma política de saúde efetiva e orientação de profissionais em busca de atendimento mais eficaz.


In Parkinson's disease (PD), a complex neurologic disorder, occurs dopamine depletion by lesions of the neurons that produce it, causing motor and cognitive impairments. The four main symptoms that affect individuals with PD are resting tremor, rigidity, bradykinesia and postural instability. These changes may increase the risk of falls and bring impairments to their activities and social participation. The aim of this study is to evaluate the functioning, disability and quality of life of PD patients cared in a physical therapy sector of an university hospital in Rio de Janeiro. Patients were assessed through the following instruments: Hoehn & Yahr Scale, quality of life questionnaire in Parkinson's disease - PDQ-39 -, Mini-mental, Berg Balance Scale, walk test of 10 meters, timed up and go test, Dynamic Gait Index, Unified Rating Scale for Parkinson's Disease and Schwab and England Scale. Although most of the individuals were on stage Hoehn & Yahr three, most showed decreased risk of fall, good cognitive and emotional state, a moderate quality of life and little difficulty in walking and performing activities of daily living (ADL). The data obtained here will serve to guide the implementation of physiotherapy measures aimed at this group of patients, managers of guidelines for an effective health policy and for the orientation of professionals in search of a more effective service.


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Doença de Parkinson/diagnóstico , Doença de Parkinson/terapia , Doença de Parkinson/epidemiologia , Exame Neurológico/métodos , Escalas de Graduação Psiquiátrica , Qualidade de Vida , Brasil/epidemiologia , Prevalência , Inquéritos e Questionários/estatística & dados numéricos , Especialidade de Fisioterapia
10.
PLoS One ; 9(4): e94824, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24732961

RESUMO

Evolutionary theories posit that emotions prime organisms for action. This study examined whether corticospinal excitability (CSE) is modulated by the emotional valence of a to-be-grasped stimulus. CSE was estimated based on the amplitude of motor evoked potentials (MEPs) elicited using transcranial magnetic stimulation (TMS) and recorded on the first dorsal interosseous (FDI) muscle. Participants were instructed to grasp (ACTION condition) or just look at (NO-ACTION condition) unpleasant, pleasant and neutral stimuli. TMS pulses were applied randomly at 500 or 250 ms before a go signal. MEP amplitudes were normalized within condition by computing a ratio for the emotion-laden stimuli by reference to the neutral stimuli. A divergent valence effect was observed in the ACTION condition, where the CSE ratio was higher during the preparation to grasp unpleasant compared to pleasant stimuli. In addition, the CSE ratio was lower for pleasant stimuli during the ACTION condition compared to the NO-ACTION condition. Altogether, these results indicate that motor preparation is selectively modulated by the valence of the stimulus to be grasped. The lower CSE for pleasant stimuli may result from the need to refrain from executing an imminent action.


Assuntos
Emoções/fisiologia , Estimulação Luminosa , Tratos Piramidais/fisiologia , Adulto , Análise de Variância , Potencial Evocado Motor/fisiologia , Humanos , Masculino , Tempo de Reação/fisiologia , Estimulação Magnética Transcraniana , Adulto Jovem
11.
Fisioter. pesqui ; 20(3): 293-298, jul.-set. 2013. ilus, tab
Artigo em Português | LILACS | ID: lil-690051

RESUMO

A ataxia espinocerebelar (SCA) é uma afecção hereditária que cursa com a degeneração progressiva do cerebelo e suas vias, causando alterações do equilíbrio e de outras funções. O efeito das abordagens da fisioterapia no tratamento da SCA e a qualidade metodológica desses estudos foram analisados. Foi investigado ainda se os benefícios alcançados com o tratamento são retidos. As intervenções encontradas incluem treino do equilíbrio, marcha e coordenação; fortalecimento; caneleiras nos membros durante exercícios e aplicação de estimulação magnética transcraniana. A retenção das melhoras obtidas com o tratamento foi relacionada ao grau de evolução da SCA e à continuidade da prática de exercícios. Porém, novos estudos com maior rigor científico são necessários para eleger as abordagens mais adequadas para o tratamento de portadores de SCA...


The spinocerebellar ataxia (SCA) is an inherited disorder that leads to progressive degeneration of the cerebellum and its pathways with impairments of balance and other functions. Physical therapy studies for SCA treatment and their methodological quality were examined. We also investigated if the benefits achieved with treatment can be retained. The interventions identified included balance, gait and coordination training; strengthening; weights around the limbs during exercise and transcranial magnetic stimulation. The long-term improvements were related to the degree of SCA evolution and the continuity of exercise practice. Nevertheless, further studies with higher scientific accuracy are necessary to elect the best physical therapy approaches for SCA patients...


La ataxia espinocerebelosa (SCA) es una afección hereditaria que cursa con la degeneración progresiva del cerebelo y de sus vías, lo que causa alteraciones del equilibrio y de otras funciones. El resultado de los abordajes de la fisioterapia en el tratamiento de la SCA y la cualidad metodológica de estos estudios fueron analizados. Se investigó si los beneficios alcanzados con el tratamiento fueron retenidos. Las intervenciones encontradas incluyen entrenamiento del equilibrio, marcha y coordinación; fortalecimiento; canilleras en los miembros durante ejercicios y aplicación de la estimulación magnética transcraneana. La retención de las mejorías obtenidas con el tratamiento fue relacionada al grado de evolución de la SCA y a la continuidad de la práctica de ejercicios. Aunque nuevos estudios con mayor carácter científico son necesarios para elegir los abordajes más adecuados para el tratamiento de los portadores de la SCA...


Assuntos
Ataxias Espinocerebelares/patologia , Ataxias Espinocerebelares/terapia , Degenerações Espinocerebelares/terapia , Ataxias Espinocerebelares/genética , Modalidades de Fisioterapia , Estimulação Magnética Transcraniana
12.
J Neurophysiol ; 109(2): 405-14, 2013 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-23136345

RESUMO

It is well established that the mental simulation of actions involves visual and/or somatomotor representations of those imagined actions. To investigate whether the total absence of vision affects the brain activity associated with the retrieval of motor representations, we recorded the readiness potential (RP), a marker of motor preparation preceding the execution, as well as the motor imagery of the right middle-finger extension in the first-person (1P; imagining oneself performing the movement) and in the third-person (3P; imagining the experimenter performing the movement) modes in 19 sighted and 10 congenitally blind subjects. Our main result was found for the single RP slope values at the Cz channel (likely corresponding to the supplementary motor area). No difference in RP slope was found between 1P and 3P in the sighted group, suggesting that similar motor preparation networks are recruited to simulate our own and other people's actions in spite of explicit instructions to perform the task in 1P or 3P. Conversely, reduced RP slopes in 3P compared with 1P found in the blind group indicated that they might have used an alternative, nonmotor strategy to perform the task in 3P. Moreover, movement imagery ability, assessed both by means of mental chronometry and a modified version of the Movement Imagery Questionnaire-Revised, indicated that blind and sighted individuals had similar motor imagery performance. Taken together, these results suggest that complete visual loss early in life modifies the brain networks that associate with others' action representations.


Assuntos
Cegueira/fisiopatologia , Variação Contingente Negativa , Desempenho Psicomotor , Adulto , Encéfalo/fisiopatologia , Dedos , Humanos , Imaginação , Masculino , Movimento
13.
PLoS One ; 7(9): e45235, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-23024811

RESUMO

BACKGROUND: Contemporary theories of motor control propose that motor planning involves the prediction of the consequences of actions. These predictions include the associated costs as well as the rewarding nature of movements' outcomes. Within the estimation of these costs and rewards would lie the valence, that is, the pleasantness or unpleasantness of a given stimulus with which one is about to interact. The aim of this study was to test if motor preparation encompasses valence. METHODOLOGY/PRINCIPAL FINDINGS: The readiness potential, an electrophysiological marker of motor preparation, was recorded before the grasping of pleasant, neutral and unpleasant stimuli. Items used were balanced in weight and placed inside transparent cylinders to prompt a similar grip among trials. Compared with neutral stimuli, the grasping of pleasant stimuli was preceded by a readiness potential of lower amplitude, whereas that of unpleasant stimuli was associated with a readiness potential of higher amplitude. CONCLUSIONS/SIGNIFICANCE: We show for the first time that the sensorimotor cortex activity preceding the grasping of a stimulus is affected by its valence. Smaller readiness potential amplitudes found for pleasant stimuli could imply in the recruitment of pre-set motor repertoires, whereas higher amplitudes found for unpleasant stimuli would emerge from a discrepancy between the required action and their aversiveness. Our results indicate that the prediction of action outcomes encompasses an estimate of the valence of a stimulus with which one is about to interact.


Assuntos
Emoções/fisiologia , Força da Mão/fisiologia , Adolescente , Adulto , Córtex Cerebral/fisiologia , Eletroencefalografia , Humanos , Masculino , Adulto Jovem
14.
Rev. psiquiatr. Rio Gd. Sul ; 27(2): 151-158, maio-ago. 2005. tab
Artigo em Português | LILACS-Express | LILACS | ID: lil-411952

RESUMO

INTRODUÇÃO: Este artigo apresenta a adaptação transcultural para o português do instrumento Peritraumatic Dissociative Experiences Questionnaire, Self-Report Version (PDEQ-SRV), para rastrear e quantificar os fenômenos dissociativos peritraumáticos. MÉTODOS: Fizeram-se duas traduções e suas respectivas retrotraduções, avaliação da equivalência semântica, elaboração da versão-síntese, pré-teste na população-alvo e realização da versão final. RESULTADOS: Observou-se um grau elevado de equivalência semântica entre o instrumento original e os dois pares de traduções/retrotraduções da perspectiva dos significados referencial e geral. O pré-teste na população-alvo conduziu a poucas modificações, que confirmaram a realização dos critérios de equivalência semântica. DISCUSSÃO: Este trabalho disponibiliza a primeira adaptação para o contexto brasileiro de um instrumento específico para a detecção e a quantificação de sintomas dissociativos peritraumáticos.

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