Adult dyskinetic cerebral palsy: Upper limb movement and muscle function.

AIM: The aim of this study was to characterize upper limb motor function during a comparative analysis of electromyographic and upper limb movement analysis during drinking between healthy adults and individuals with DCP. METHOD: Fifteen healthy individuals (CG) and fifteen individuals with DCP (DG) participated in the study. Upper limb function was analyzed during drinking and consisted of a task divided into three phases: the going, the adjustment, and the return. RESULTS: Electromyographic analysis revealed a lower activity of the anterior deltoid, posterior deltoid, and biceps brachii muscles in the DG. When comparing the interactions between groups and phases, only biceps brachii shower lower muscle activity during going and adjustment phases. The DG presented a smaller range of motion (ROM) for the shoulder, elbow, forearm and wrist movements. An interaction between groups and phases showed smaller ROM for the flexion and internal rotation of the shoulder, elbow flexion, forearm pronation, and ulnar deviation in the return phase compared to CG. INTERPRETATION: The results may contribute positively to the quantification of the level of motor impairment and may be used as a reference for the development of therapeutic interventions for patients with DCP.

Visual biofeedback balance training using wii fit after stroke: a randomized controlled trial.

[Purpose] The aim of the present study was to investigate the effect of balance training with visual biofeedback on balance, body symmetry, and function among individuals with hemiplegia following a stroke. [Subjects and Methods] The present study was performed using a randomized controlled clinical trial with a blinded evaluator. The subjects were twenty adults with hemiplegia following a stroke. The experimental group performed balance training with visual biofeedback using Wii Fit(®) together with conventional physical therapy. The control group underwent conventional physical therapy alone. The intervention lasted five weeks, with two sessions per week. Body symmetry (baropodometry), static balance (stabilometry), functional balance (Berg Balance Scale), functional mobility (Timed Up and Go test), and independence in activities of daily living (Functional Independence Measure) were assessed before and after the intervention. [Results] No statistically significant differences were found between the experimental and control groups. In the intragroup analysis, both groups demonstrated a significant improvement in all variables studied. [Conclusion] The physical therapy program combined with balance training involving visual biofeedback (Wii Fit(®)) led to an improvement in body symmetry, balance, and function among stroke victims. However, the improvement was similar to that achieved with conventional physical therapy alone.

The immediate effect of different loads does not alter muscle co-activation of the upper limb in young adults with dyskinetic cerebral palsy.

BACKGROUND: There is insufficient information on muscle co-activation in the upper limbs to help healthcare providers develop treatment programs for patients with dyskinetic cerebral palsy (DCP). RESEARCH QUESTION: Is the degree of muscle co-activation greater in adults with DCP than in healthy individuals? Does the use of different arm weights modify co-contraction in individuals with PCD? METHODS: Fourteen healthy individuals (control group [CG]) and 14 individuals with DCP (dyskinetic group [DG]) participated in the study. The degree of muscle co-activation of the dominant limb during drinking from a mug was compared between the two groups. The task was divided into a going, adjusting, and returning phase. In the DG, an analysis was also performed on using an arm weight during the functional task. The loads corresponded to 10, 20, and 30 % of maximum isometric muscle strength measured in each participant. RESULTS: In comparing the two groups, the DG exhibited a greater muscle co-activation in the shoulder and elbow muscles during the going phase, the shoulder, elbow, and wrist during the adjusting phase; and the elbow during the returning phase. The DG also showed a greater mean index of curvature (MIC), time to perform the movement phases, and lesser mean velocity (Vm) to drinking. In analyzing the DG's arm weight, no effect on co-activation, MIC, time to perform the movement phases, and Vm to drinking were found with the loads tested (p > 0.05). CONCLUSION: Muscle co-activation is increased in adults with DCP in comparison to healthy individuals. Moreover, arm weight during the functional activity of drinking from a mug did not alter co-activation, although an immediate effect was expected.

Análise do equilíbrio em pacientes hemiparéticos após o treino com o programa Wii Fit / Balance analysis in hemiparetics patients after training with Wii Fit program

Objetivo: A hemiparesia é um comprometimento parcial do hemicorpo que altera o equilíbrio, sendo este essencialpara as atividades funcionais. Objetivo: Avaliar o equilíbrio em pacientes hemiparéticos submetidosao treino de equilíbrio com o programa Wii Fit, que atuou como um recurso de biofeedback visual. Método: Foram selecionados 12 pacientes hemiparéticos pós AVE, 5 do sexo masculino e 7 do sexo feminino, comidade média de 58 ± 12,57 anos, divididos aleatoriamente em dois grupos. Um deles realizou a fisioterapiaconvencional (GC) pelo período de uma hora, o outro realizou por trinta minutos e mais trinta minutos de treino de equilíbrio com auxílio do Wii Fit (GW), duas vezes por semana durante cinco semanas, completando dez sessões. O equilíbrio foi avaliado antes e após as intervenções, por meio da aplicação da Escala de Equilíbrio de Berg (EEB) e pela estabilometria, que mensura a oscilação do centro de pressão (COP),nos eixos ântero-posterior (AP) e médio-lateral (ML), por uma plataforma de pressão em duas condições: de olhos abertos (OA) e olhos fechados (OF). Resultados: De acordo com a EEB, os pacientes, tanto do GC quanto o do GW, obtiveram maior controle do equilíbrio estático e dinâmico. Na avaliação do COP no eixo ML, os indivíduos do GC e do GW tiveram diminuição na oscilação ML após a intervenção proposta para cada grupo, nas condições de OA e OF. No eixo AP do COP, o GC não teve diminuição na oscilação AP de OA e OF, eo GW apresentou diminuição na oscilação AP de OA e OF. Conclusão: O presente estudo demonstra que a fisioterapia associada ao treino de equilíbrio com o Wii Fit apresenta resultados significantes na reabilitaçãodos indivíduos hemiparéticos, obtendo, assim, mais um recurso terapêutico na fisioterapia.

Aplicação da bola terapêutica na evolução do equilíbrio em pacientes hemiparéticos / Application of ball therapy in hemiparetic

Introdução: O acidente vascular encefálico (AVE) é uma doença comum mundialmente, sendo uma das principais causas de incapacidade neurológica em adultos, geralmente acomete a função dos membros, o controle motor, o equilíbrio, a força e a mobilidade, sendo que para todas estas funções é necessário apresentar equilíbrio. O principal comprometimento motor é a hemiparesia, caracterizada pela perda parcial das funções motoras, incluindo déficit da mobilidade e a fraqueza muscular de um hemicorpo. A fisioterapia é fundamental nestes casos, ocorrendo uma melhor recuperação motora e funcional. Objetivo: Verificar a aplicação de exercícios com bola terapêutica na evolução do equilíbrioem pacientes hemiparéticos. Método: Participaram do estudo nove pacientes adultos hemiparéticos com idade 58,67 ±14,09 anos com seqüelas pós AVE e que apresentam déficits de equilíbrio, de ambos os sexos, submetidos a um programa de reabilitação de dez sessões. Conteve nove exercícios de tronco utilizando a bola terapêutica, visandotrabalhar a flexibilidade, a força, endurance, coordenação, consciência corporal e equilíbrio, sendo o tronco a base para a aquisição de equilíbrio. A própria bola já propicia um desequilíbrio, necessitando, consequentemente, da reorganização das reações de equilíbrio, que são fundamentais para as atividades de vida diária e a independência funcional. Resultados: Os resultados foram significantes e expressos em mediana, onde a pré intervenção obteve 43 pontos e pós intervenção 48 pontos (p=O,OOl). Conclusão: Os exercícios propostos com a bola terapêutica apresentaram melhora no equilíbrio dos pacientes hemiparéticos. Sendo um recurso acessível na reabilitação.

Introduction: Cerebrovascular accident (CVA) is a common disease worldwide and a leading cause of neurological disability in adults, usually affects the function of the limbs, motor control, balance, strength and mobility, and for ali these functions is must be balanced. One of the main motor impairment in hemiplegia is characterized by partial loss of motor function, including a deficit of mobility and muscie weakness of one hemisphere. Physical therapy is essential in these cases, occurring a better motor recovery and funcional. Objective: Verify the application of therapeutic ball exercises with the evolution of balance in hemiparetic patients. Method: Participated study of nine adult patients with hemiparetic age 58.67 ± 14.09 years with sequei after stroke and who have deficits in balance of both sexes, submitted to a rehabilitation program of ten sessions, contained nine exercises using the ball stem therapy, aiming to work on flexibility, strength, endurance, coordination, body awareness and balance, and the stem base to acquire balance. The ball itself already providesan imbalance, requiring, therefore, the reorganization of the balance reactions, which is fundamental to the activities of daily living and functional independence. Results: The results were significant and expressed as median, where the pre-treatment was 43 points and post-intervention was 48 points (p = 0.001). Conclusion: The proposed exercises with the ball therapy showed improvement in the balance of hemiparetic patients. Being an accessible resource rehabilitation.