[Multiple sclerosis: cross-cultural adaptation and validation of the modified fatigue impact scale]. / Esclerose múltipla: adaptação transcultural e validação da escala modificada de impacto de fadiga.

OBJECTIVE: The aim of this study is a cross-cultural adaptation and validation of the modified fatigue impact scale for Portuguese (MFIS-BR). METHOD: The MFIS was translated to Portuguese and re-translated to English. Two pilot studies had been carried through to obtain the MFIS-BR, which was applied to 57 consecutive stable MS patients and 45 healthy controls. The retest was applied 30 days later. RESULTS: In analyzing the statistics the internal consistency reability was similar to the original scale (0.74-0.86). The MFIS-BR showed ability to identify the different groups. Concerning the reliability the interclass correlation coefficient showed an excellent agreement (0.264-1.0). CONCLUSION: The MFIS-BR fills the criteria of applicability, sensibility which are similar to the original version.

[Vestibular rehabilitation in patients with relapsing-remitting multiple sclerosis]. / Reabilitação vestibular em pacientes com esclerose múltipla remitente-recorrente.

Multiple sclerosis (MS) is a demyelinating, inflammatory illness, that attack the white matter of the central nervous system, and abnormal vestibular sensations (vertigo, disequilibrium) are frequent. The vestibular rehabilitation (VR) is determined by mechanisms of adaptations, neural substitutions and compensations. This study evaluated the improvement of the central or peripheral vertigo in patients with relapsing-remitting MS submitted to the VR (exercises of Cawthorne-Cooksey), through the scale of Berg and Dizziness Handicap Inventory (DHI). In this sample of 4 cases the VR, carried through in a period of 2 months, demonstrated the improvement in 3 patients according to the Berg scale and in 2 patients considering that of the DHI.

[Fatigability evaluation on multiple sclerosis patients by using a hand held dynamometer]. / Avaliação da fatigabilidade em pacientes com esclerose múltipla através do dinamômetro manual.

Fatigue is one of the most common disabling symptoms in multiple sclerosis (MS). The aim of this study was to evaluate the fatigability on patients with MS by the application of hand grip isotonic and isometric exercises with dynamometer. As results the fatigability, the isometric strength and time were statistically similar in the control group and in MS. We conclude that although fatigue is a frequent subjective complaint on MS, the fatigability and the recover after exercises seems to be normal.

Cross-cultural adaptation and validation of the 12-item Multiple Sclerosis Walking Scale (MSWS-12) for the Brazilian population.

UNLABELLED: Gait impairment is reported by 85% of patients with multiple sclerosis (MS) as main complaint. In 2003, Hobart et al. developed a scale for walking known as The 12-item Multiple Sclerosis Walking Scale (MSWS-12), which combines the perspectives of patients with psychometric methods. OBJECTIVE: This study aimed to cross-culturally adapt and validate the MSWS-12 for the Brazilian population with MS. METHODS: This study included 116 individuals diagnosed with MS, in accordance with McDonald's criteria. The steps of the adaptation process included translation, back-translation, review by an expert committee and pretesting. A test and retest of MSWS-12/BR was made for validation, with comparison with another scale (MSIS-29/BR) and another test (T25FW). RESULTS: The Brazilian version of MSWS-12/BR was shown to be similar to the original. The results indicate that MSWS-12/BR is a reliable and reproducible scale. CONCLUSIONS: MSWS-12/BR has been adapted and validated, and it is a reliable tool for the Brazilian population.

Cross-cultural adaptation and validation of als Functional Rating Scale-Revised in Portuguese language.

The aim of this study is the cross-cultural, as well as to validate in Portuguese language the Amyotrophic Lateral Sclerosis Functional Rating Scale - Revised (ALSFRS-R). We performed a prospective study of individuals with amyotrophic lateral sclerosis (ALS) clinically defined. The scale, after obtaining the final version in Portuguese, was administered in 22 individuals and three weeks after re-applied. There were no significant differences between the application and reapplication of the scale (p=0.069). The linear regression and internal consistency measured by Pearson correlation and alpha Conbrach were significant with r=0.975 e alpha=0.934. The reliability test-retest demonstrated by intraclass correlation coefficient was strong with ICC=0.975. Therefore, this version proved to be applicable, reliable and easy to be conducted in clinical practice and research.

Validation of the "Six Step Spot Test" for gait among patients with multiple sclerosis in Brazil.

The clinical manifestations of multiple sclerosis (MS) are variable among patients, and the course of disease is not linear. Different symptoms are presented, with gradual accumulation of disability. These variations are difficult to quantify in clinical practice, and several studies have attempted to create instruments capable of measuring these disabilities. The Six Step Spot Test (SSST) was developed for quantitative evaluation of the lower limbs (LL) over time. Performance in this test reflects the complexity of sensory-motor function, including LL strength, spasticity, coordination and balance, going beyond vision and cognition. The aim of the present study was to validate the SSST in a population of MS patients in Brazil. This prospective study included 75 patients with MS, with EDSS 0 to 6.5 in the study group. Ninety-one healthy subjects were randomly selected for the control group. The results showed that the groups were similar, and that the SSST is a reliable and reproducible test. According to the statistical analysis on the data in this study, the SSST is a valid, reliable and reproducible tool for use in the Brazilian MS patient population.

Validation of the Amyotrophic Lateral Sclerosis Assessment Questionnaire (ALSAQ-40) scale in the Portuguese language.

The amyotrophic lateral sclerosis (ALS) is a degenerative neurological disorder that has a great impact in the quality of life of the patients. This study had the objective of validating the ALS Assessment Questionnaire in the Portuguese Language (ALSAQ-40/BR). The version of ALSAQ-40/BR, was adapted into the Portuguese language after the evaluation and re-evaluation of 20 patients with a defined ALS diagnosis. The demonstration of its reproducibility and reliability makes this instrument an additional and useful parameter which can be used in the evaluation of ALS for research or assistance.

Cross-cultural adaptation and validation of the Rivermead Mobility Index in stroke patients within the brazilian cultural and language context.

The aim of this project is to carry out the cross-cultural adaptation and validation of the assessment instrument known as the Rivermead Mobility Index (RMI) within the Brazilian cultural context and in Brazilian Portuguese for people suffering from strokes. The RMI was translated into Portuguese and translated back into English by independent bi-lingual translators, preserving the characteristics of the psychometrics in the original scale. After the formulation of the final version, a test and retest were carried out with an interval of one week. Ninety-five stroke patients took part in the study. The results obtained for sensibility, specificity and reliability were high We conclude that the Brazilian version of the RMI (RMI-BR) is a valid tool for Brazilian stroke patients.

Validation of the Santa Casa evaluation of spasticity scale.

Spasticity is a clinical condition that has negative repercussions on function. A scale capable of quantifying the severity and impact of an injury is fundamental to the rehabilitation process. The objective of this study was to retest and validate the Santa Casa evaluation of spasticity scale, a descriptive assessment of activities of daily living, transfers and locomotion. We analyzed spasticity and functional status in 97 hemiparetic patients. With statistical significance (p<0.05), this new scale demonstrated reliability in assessing clinical-functional conditions and reproducibility as a daily assessment scale for use during rehabilitation.

Toxina botulínica na espasticidade: a importância da fisioterapia - parte 02 / Boltulinum toxin in spasticity: the importance of physiotherapy

A espasticidade pode trazer sérias conseqüências ao paciente, como contraturas e deformidades que irão afetar o desenvolvimento das habilidades funcionais. A fisioterapia proporciona condições para facilitar o controle do tônus e dos movimentos, aquisições de posturas e de padrões normais, pois visa à inibição da atividade reflexa patológica e à facilitação do movimento normal. Entre os diversos recursos fisioterapêuticos existentes, os mais utilizados para adequação do tônus são: cinesioterapia, eletroterapia e mecanoterapia. A TBA é uma das soluções encontradas pela ciência para auxiliar no controle da espasticidade, e, como tal, deve ser utilizada de maneira adequada para melhorar a qualidade de vida do paciente. No entanto, para que sua eficácia seja plena, é importante que haja uma boa interação entre a equipe multidisciplinar que acompanha o paciente. Conclusão: O fisioterapeuta é o profissional qualificado para para potencialização dos efeitos da TXBA buscando o reequilíbrio muscular, organização neurológica e melhora funcional do paciente espástico.

Toxina botulínica na espasticidade: a importância da fisioterapia (parte 1) / Botulinum toxin in spasticity: the importance of physiotherapy

Para realização do movimento com harmonia é necessário o controle da motricidade voluntária e do tônus muscular, exercido pelo sistema corticoespinal. A lesão deste sistema acarretará perda do controle dos movimentos e aumento do tônus, a espasticidade. O tratamento com a TXBA é um procedimento auxiliar importante no controle da espasticidade. O papel do fisioterapeuta é avaliar a capacidade motora do sistema neuromusculoesquelético e qual a interferência da espasticidade na função motora do paciente. Conclusão: A TXBA é um recurso terapêutico no tratamento da espasticidade, potencializando o resultado do programa de Reabilitação por reduzir o tônus indesejado por tempo prolongado. A indicação da TXBA é abrangente e interdisciplinar cabendo ao fisioterapeuta importante papel na avaliação da capacidade funcional residual do paciente visando a obter o máximo do potencial de reabilitação.

Cross-cultural adaptation and validation of the 12-item Multiple Sclerosis Walking Scale (MSWS-12) for the Brazilian population / Adaptação transcultural e validação da 12-item Multiple Sclerosis Walking Scale (MSWS-12) para a população brasileira

Gait impairment is reported by 85% of patients with multiple sclerosis (MS) as main complaint. In 2003, Hobart et al. developed a scale for walking known as The 12-item Multiple Sclerosis Walking Scale (MSWS-12), which combines the perspectives of patients with psychometric methods. OBJECTIVE: This study aimed to cross-culturally adapt and validate the MSWS-12 for the Brazilian population with MS. METHODS: This study included 116 individuals diagnosed with MS, in accordance with McDonald's criteria. The steps of the adaptation process included translation, back-translation, review by an expert committee and pretesting. A test and retest of MSWS-12/BR was made for validation, with comparison with another scale (MSIS-29/BR) and another test (T25FW). RESULTS: The Brazilian version of MSWS-12/BR was shown to be similar to the original. The results indicate that MSWS-12/BR is a reliable and reproducible scale. CONCLUSIONS: MSWS-12/BR has been adapted and validated, and it is a reliable tool for the Brazilian population.

Distúrbios da marcha são relatados em 85% de pacientes com esclerose múltipla (EM), sendo uma de suas principais queixas. Hobart et al. desenvolveram uma escala de deambulação conhecida como The 12-item Multiple Sclerosis Walking Scale (MSWS-12) que associa as perspectivas dos pacientes com os métodos psicométricos. OBJETIVO: Realizar a adaptação transcultural e validar a MSWS-12 para a população brasileira com EM. MÉTODO: Participaram 116 indivíduos com EM definida segundo os critérios propostos por McDonald. As etapas do processo de adaptação transcultural foram tradução, retradução, revisão por um comitê de especialistas e pré-teste. Para validação, foi realizado teste e reteste da MSWS-12/BR, e comparação com MSIS-29 e T25FW. RESULTADOS: Após a adaptação transcultural da MSWS-12/ BR, observamos que a versão brasileira está semelhante à original. Os resultados mostraram que a MSWS-12/BR é uma escala confiável e reprodutível. CONCLUSÕES: A MSWS-12/BR foi adaptada adequadamente e é válida e confiável para a população brasileira.

Padronização do teste de alcance funcional em pacientes com esclerose múltipla / Standartization of the functional reach test in patients with multiple sclerosis

Objetivos: Padronizar os testes de alcance funcional para pacientes com Esclerose Múltipla (EM). Materiais e Métodos: 40 indivíduos com EM que realizaram os testes e re-testes de alcance funcional, uma semana de diferença. Os dados do Expanded Disability Status Scale (EDSS) foram colhidos do prontuário. Resultados: boa reprodutividade com ICC de 0,836; 0,859 e 0,859 para o teste de alcance anterior, e laterais direita e esquerda, respectivamente. Os testes não apresentaram correlação com idade, EDSS, comprimento de membros superiores, lateralidade, número de calçado, altura e peso. Conclusão: os testes apresentaram boa reprodutividade podendo ser padronizado para a população com EM.

Desempenho cognitivo nos pacientes com esclerose múltipla: follow up de cinco anos / Cognitive performance in patients with multiple sclerosis: follow up to five years

A deterioração cognitiva pode ocorrer na Esclerose Múltipla (EM) ao longo do tempo levando a um forte impacto da qualidade de vida. A proposta deste estudo ao investigar como se apresentam as funções cognitivas num período de cinco anos e compará-las com a incapacidade física. Avaliamos 30 pacientes (23 mulheres e sete homens) quando ingressaram no CATEM e após cinco anos, através de testes neuropsicológicos avaliando a memória recente, funções executivas, atenção concentrada, atenção complexa que envolve as funções executivas do lobo frontal. Houve melhora da capacidade do aprendizado nas duas primeiras tentativas do teste de memória e de evocação tardia. Estavam intactas a memória operacional, atenção complexa e funções executivas e piora do desempenho da memória lógica tanto da evocação imediata quanto a tardia e da atenção concentrada quanto a velocidade do processamento

The cognitive deterioration can occurin multiple sclerosis (MS) over timeleading to a strong impact on quality oflife. The purpose of this study is to investigate how cognitive functions arepresented in a period of five years. Weevaluated 30 patients (23 women andseven men) when entered the CATEMand after five years, through neuropsychological tests assessing short-term memory, executive functions, focused attention, complex attention that involves the executive functions of the frontal lobe. Improvement of learningability in the first two attempts to testmemory and delayed recall. Were intactworking memory, complex attentionand executive functions, and worseningof memory performance logic of both the immediate and delayed recalland focused attention on the processingspeed.

Comportamento da Incontinência urinária em pacientes com esclerose múltipla e a sua influência na qualidade de vida / Urinary incontinence behavior in patients with Multiple Sclerosis andits influence in quality of life

Este estudo avaliou o comportamentoda incontinência urinária (IU) e sua interferência na qualidade de vida na EscleroseMúltipla (EM) através da aplicaçãodo questionário de qualidade de vida condição-específico International Consultationon Incontinence Questionnaire ? Short Form (ICIQ-SF) em 53 pacientes do Centro de Atendimento e Tratamento de Esclerose Múltipla da Santa Casa de São Paulo. Concluiu-se que a IU é um sintoma de grande incidência na EM (59%), na forma de urge-incontinência e mista e a perda urinária apresenta-se em pequena quantidade, mas é um fator de alto impacto na qualidade de vida.

This study evaluated the urinary incontinence (UI) behavior and its interference in quality of life in patients with Multiple Sclerosis (MS) through the application of the International Consultation on Incontinence Questionnaire ? Short Form (ICIQ-SF) in 53 patients from Centro de Atendimento e Tratamento de Esclerose Múltipla from Irmandade Santa Casa de Misericórdia de São Paulo. We concluded that the UI is a symptom of great incidence in the one MS (59%) in form of urge-incontinence and mixed incontinence and the urinary loss is presented in small amount however it is a factor of high impact in the quality of life.

Cross-cultural adaptation and validation of als Functional Rating Scale-Revised in Portuguese language / Adaptação transcultural e validação da als Functional Rating Scale-Revised para a língua portuguesa

The aim of this study is the cross-cultural, as well as to validate in Portuguese language the Amyotrophic Lateral Sclerosis Functional Rating Scale - Revised (ALSFRS-R). We performed a prospective study of individuals with amyotrophic lateral sclerosis (ALS) clinically defined. The scale, after obtaining the final version in Portuguese, was administered in 22 individuals and three weeks after re-applied. There were no significant differences between the application and reapplication of the scale (p=0.069). The linear regression and internal consistency measured by Pearson correlation and alpha Conbrach were significant with r=0.975 e α=0.934. The reliability test-retest demonstrated by intraclass correlation coefficient was strong with ICC=0.975. Therefore, this version proved to be applicable, reliable and easy to be conducted in clinical practice and research.

O objetivo deste estudo foi realizar a adaptação transcultural, bem como validar na língua portuguesa a Amyotrophic Lateral Sclerosis Functional Rating Scale - Revised (ALSFRS-R). Foi realizado um estudo prospectivo com indivíduos com esclerose lateral amiotrófica clinicamente definida. A escala, após a obtenção da sua versão final em português, foi aplicada em 22 indivíduos em dois momentos com intervalo de três semanas. Não foram observadas diferenças significativas entre a aplicação e reaplicação da escala (p=0,069). A fidedignidade e a consistência interna mensuradas pela correlação de Pearson e alfa de Conbrach foram significativos com r=0,975 e α=0,934, respectivamente. A confiabilidade evidenciada pelo coeficiente de correlação intraclasse foi forte com ICC=0,975. Portanto, a versão em português da ALSFRS-R demonstrou ser reprodutível, confiável, de fácil aplicação e compreensão para prática clínica e pesquisa.

Validation of the "Six Step Spot Test" for gait among patients with multiple sclerosis in Brazil / Validação do teste de marcha "Six Step Spot Test" em pacientes com esclerose múltipla no Brasil

The clinical manifestations of multiple sclerosis (MS) are variable among patients, and the course of disease is not linear. Different symptoms are presented, with gradual accumulation of disability. These variations are difficult to quantify in clinical practice, and several studies have attempted to create instruments capable of measuring these disabilities. The Six Step Spot Test (SSST) was developed for quantitative evaluation of the lower limbs (LL) over time. Performance in this test reflects the complexity of sensory-motor function, including LL strength, spasticity, coordination and balance, going beyond vision and cognition. The aim of the present study was to validate the SSST in a population of MS patients in Brazil. This prospective study included 75 patients with MS, with EDSS 0 to 6.5 in the study group. Ninety-one healthy subjects were randomly selected for the control group. The results showed that the groups were similar, and that the SSST is a reliable and reproducible test. According to the statistical analysis on the data in this study, the SSST is a valid, reliable and reproducible tool for use in the Brazilian MS patient population.

As manifestações clínicas da esclerose múltipla (EM) são variáveis e o curso da doença não é linear, caracterizado por sintomas, acúmulo progressivo de incapacidades. Estas variações são difíceis de quantificar na prática clínica, motivo pelo qual surgiram diversos estudos para criação de instrumentos capazes de mensurar essas incapacidades. O Six Step Spot Test (SSST) foi desenvolvido para avaliar função dos membros inferiores (MMII) de forma quantitativa, mensurado no domínio tempo, avaliando a complexa função sensório-motora, como força em MMII, espasticidade, coordenação e equilíbrio, além da visão e cognição. Este estudo teve como objetivo validar o SSST para pacientes com EM no Brasil. Estudo prospectivo do qual participaram 75 pacientes com EM e EDSS de 0 a 6,5 no grupo de estudo e 91 indivíduos saudáveis no controle que foram selecionados aleatoriamente. Segundo os dados estatísticos deste estudo, o SSST é válido, confiável e reprodutível para pacientes com EM no Brasil.

Reabilitação vestibular em pacientes neurológicos / Vestibular rehabilitation in neurological patients

O acidente vascular cerebral (AVC) constitui condições de comprometimento central, que de forma frequente cursam com alterações do equilíbrio. O objetivo do presente estudo foi verificar se há adaptação do sistema vestibular e conseguinte melhora da vertigem e qualidadede vida (QV) em pacientes com AVC. Os resultados mostram melhorana QV principalmente no aspecto funcional. Em conclusão, este estudo inicial sugere que a Reabilitação Vestíbulo - Ocular melhora os sintomas da vertigem em pacientes com AVC e diminui o impacto da vertigem na QV.

Cross-cultural adaptation and validation of the Rivermead Mobility Index in stroke patients within the brazilian cultural and language context / Adaptação transcultural e validação do instrumento Rivermead Mobility Index para pessoas com acidente vascular cerebral no contexto cultural brasileiro e português brasileiro

The aim of this project is to carry out the cross-cultural adaptation and validation of the assessment instrument known as the Rivermead Mobility Index (RMI) within the Brazilian cultural context and in Brazilian Portuguese for people suffering from strokes. The RMI was translated into Portuguese and translated back into English by independent bi-lingual translators, preserving the characteristics of the psychometrics in the original scale. After the formulation of the final version, a test and retest were carried out with an interval of one week. Ninety-five stroke patients took part in the study. The results obtained for sensibility, specificity and reliability were high We conclude that the Brazilian version of the RMI (RMI-BR) is a valid tool for Brazilian stroke patients.

O objetivo deste estudo foi realizar a adaptação transcultural e validação do instrumento de avaliação conhecida como the Rivermead Mobility Index (RMI) no contexto cultural brasileiro e no Português Brasileiro para pessoas que sofreram acidente vascular cerebral. O RMI foi traduzido para o Português e retraduzido para o Inglês por tradutores independentes bilingues, preservando as características psicométricas da escala original. Após a formulação da versão final, teste e reteste foram realizados com intervalo de uma semana. Noventa e cinco pacientes que sofreram acidente vascular cerebral participaram do estudo. Os resultados obtidos para sensibilidade, especificidade e confiabilidade foram elevados. Nós concluímos que a versão brasileira do RMI (RMI-BR) é um instrumento válido para pacientes brasileiros com AVC.

Validation of the Amyotrophic Lateral Sclerosis Assessment Questionnaire (ALSAQ-40) scale in the portuguese language / Validação da escala ALSAQ-40 em pacientes com esclerose lateral amiotrófica para a língua portuguesa

The amyotrophic lateral sclerosis (ALS) is a degenerative neurological disorder that has a great impact in the quality of life of the patients. This study had the objective of validating the ALS Assessment Questionnaire in the Portuguese Language (ALSAQ-40/BR). The version of ALSAQ-40/BR, was adapted into the Portuguese language after the evaluation and re-evaluation of 20 patients with a defined ALS diagnosis. The demonstration of its reproducibility and reliability makes this instrument an additional and useful parameter which can be used in the evaluation of ALS for research or assistance.

Esclerose lateral amiotrófica, doença neurológica degenerativa, apresenta grande impacto na qualidade de vida dos pacientes. Este estudo teve como objetivo realizar a adaptação transcultural e validação da escala Amyotrophic Lateral Sclerosis Assessment Questionnaire (ALSAQ-40) nestes pacientes. Foi aplicada em 20 pacientes com reteste após 30 dias. A tradução para o português e sua adequação às condições socioeconômicas e culturais da nossa população, bem como a demonstração de sua reprodutibilidade e validade, tornam este instrumento um parâmetro adicional útil que pode ser utilizado na avaliação da ELA seja em nível de pesquisa ou assistencial.