Relationships of Balance, Gait Performance, and Functional Outcome in Chronic Stroke Patients: A Comparison of Left and Right Lesions.

INTRODUCTION: This study compared the balance by center of pressure (COP) and its relationship with gait parameters and functional independence in left (LH) and right (RH) chronic stroke patients. METHODS: In this cross-sectional study, twenty-one hemiparetic stroke patients were assessed for Functional Independence Measure (FIM), balance with a force platform, and gait in the Motion Analysis Laboratory. RESULTS: The amplitudes of the COP in the anteroposterior and mediolateral directions were similar in both groups. The anteroposterior direction was greater than the mediolateral direction. Only the temporal parameters showed any statistically significant differences. The LH showed a significant correlation between stride length, step length, and gait velocity with COP velocity sway for the healthy and paretic lower limbs. In both groups, the area of COP was significantly correlated with stride length. Motor FIM was significantly correlated with the COP in the LH group. CONCLUSION: There was no difference in the performance of balance, gait, and functional independence between groups. The correlation of the COP sway area with stride length in both groups can serve as a guideline in the rehabilitation of these patients where training the static balance may reflect the improvement of the stride length.

Serum levels of proinflammatory cytokines in painful knee osteoarthritis and sensitization.

Osteoarthritis (OA) is the most common joint disorder in the world. Among the mechanisms involved in osteoarthritis, biomarkers (cytokines profile) may be related to pain and pain intensity, functional capacity, and pressure pain thresholds (PPT). Thus, the study of these relationships may offer useful information about pathophysiology and associated mechanisms involved in osteoarthritis. Therefore, the objective of this study was to investigate the seric concentration of pro (IL-6, IL-8, and TNF-α) and anti-inflammatory (IL-10) cytokines in patients with painful knee osteoarthritis and to correlate the levels of these biomarkers with the patients' functional capacity and pressure pain threshold (PPT) values.

Efficacy of transcranial direct current stimulation coupled with a multidisciplinary rehabilitation program for the treatment of fibromyalgia.

UNLABELLED: Pain control in fibromyalgia patients is limited no matter the therapeutic regimens used. Recent data have shown that daily sessions of anodal transcranial direct current stimulation (tDCS) over the primary motor cortex (M1) in patients with fibromyalgia (FM) are associated with reduction of pain perception. OBJECTIVE: We aimed to test whether active tDCS, as compared with sham tDCS, combined with multidisciplinary rehabilitation is associated with significant clinical gains in fibromyalgia. DESIGN: This was a randomized, double-blinded controlled trial. SUBJECTS: 23 patients were randomized to receive weekly sessions of multidisciplinary rehabilitation approach combined with sham or anodal tDCS of M1. Patients were evaluated for pain with VAS and for quality of life with SF-36, fibromyalgia pain questionnaire and health assessment questionnaire by a blinded rater before and after the 4 month period of rehabilitation. RESULTS: Patients tolerated tDCS treatment well, without adverse effects. Patients who received active treatment had a significantly greater reduction of SF-36 pain domain scores (F((2,21))=6.57; p=0.006) and a tendency of higher improvement in Fibromyalgia Impact Questionnaire (FIQ) scores after (p=0.056) as compared with sham tDCS/standard treatment, but no differences were observed in the other domains. CONCLUSIONS: Although active tDCS was associated with superior results in one domain (SF-36 pain domain), the lack of significance in the other domains does not fully support this strategy (weekly tDCS) combined with a multidisciplinary approach.