Effect of a single session of transcranial direct-current stimulation combined with virtual reality training on the balance of children with cerebral palsy: a randomized, controlled, double-blind trial.

[Purpose] The aim of the present study was to investigate the effects of a single session of transcranial direct current stimulation combined with virtual reality training on the balance of children with cerebral palsy. [Subjetcs and Methods] Children with cerebral palsy between four and 12 years of age were randomly allocated to two groups: an experimental group which performed a single session of mobility training with virtual reality combined with active transcranial direct current stimulation; and a control group which performed a single session of mobility training with virtual reality combined with placebo transcranial direct current stimulation. The children were evaluated before and after the training protocols. Static balance (sway area, displacement, velocity and frequency of oscillations of the center of pressure on the anteroposterior and mediolateral axes) was evaluated using a force plate under four conditions (30-second measurements for each condition): feet on the force plate with the eyes open, and with the eyes closed; feet on a foam mat with the eyes open, and with the eyes closed. [Results] An increase in sway velocity was the only significant difference found. [Conclusion] A single session of anodal transcranial direct current stimulation combined with mobility training elicited to lead to an increase in the body sway velocity of children with cerebral palsy.

Clinical analysis and baropodometric evaluation in diagnosis of abnormal foot posture: A clinical trial.

Foot posture involves the integration of sensory information from the periphery of the body. This information generates precise changes through fine adjustments that compensate for the continuous, spontaneous sway of the body in the standing position. Orthopedic insoles are one of the therapeutic resources indicated for assisting in this process. Evaluation of these podal influences, by clinical examination and/or the assistance of baropodometry becomes crucial. Thus, the aim of the present study was determine the combination of the components of orthopedic insoles using two different evaluation methods. Forty healthy female volunteers between 18 and 30 years participated in the study. The volunteers were submitted to two different evaluations: clinical analysis and baropodometry. During the exams, different insole components were tested. The statistical analysis of the two evaluations revealed differences regarding the normalization of posture following the application of the insole components and in the determination of the combination of these components. The findings suggest that the clinical analysis is a fast and accurate method for determining the immediate benefits of the postural insole components and is therefore the more indicated method for the evaluation of foot posture, but does not present a concrete foundation to differentiate it with respect to baropodometric evaluation in the assessment and diagnosis of foot posture, however, a greater difficulty was encountered in achieving posture normalization when using information obtained through baropodometry.

Analysis of electromyographic activity of ankle muscles on stable and unstable surfaces with eyes open and closed.

INTRODUCTION: Proprioceptive exercises are performed on a daily basis in physiotherapy with the use of different unstable platforms in order to improve joint stability using the mechanical and sensory properties of ligaments, joint capsule and integrated activity of the muscles surrounding the joint. Changes in the myoelectrical characteristics of the muscles during activity can be identified using surface electromyography (EMG), which provides important information on the behavior of muscles submitted to different types of load. OBJECTIVES: The aim of the present study was to analyze the electromyographic activity of the tibialis anterior, tibialis posterior, peroneus longus, gastrocnemius lateralis and gastrocnemius medialis on stable and unstable surfaces with eyes open and closed. METHODOLOGY: Twenty-five active, healthy, male and female individuals were submitted to an anthropometric evaluation and a protocol involving warm up and the electromyographic assessment of muscle activity on different surfaces. The order of the data collection was chosen randomly by lots [on stable ground or unstable platforms (trampoline, balance platform, proprioceptive disk and proprioceptive board) with eyes open and on a trampoline, balance platform and stable ground with eyes closed]. The individuals remained balanced on these surfaces for 15 s with the knee at 30° flexion in order to provide greater instability. RESULTS: There was a significant increase (p < 0.05) in muscle activity on the unstable surfaces, with the exception of the trampoline, which did not achieve statistically significant differences in relation to the stable ground. The tibialis anterior and peroneus longus exhibited the greatest electromyographic activity on all surfaces. The proprioceptive tests performed with eyes closed exhibited significantly greater electromyographic activity than with eyes open. CONCLUSION: Proprioceptive exercises on unstable surfaces generated a significant increase in electromyographic activity, especially with eyes closed, and are therefore a valuable resource in the sensory-motor rehabilitation of the ankle.