Responsiveness of the Gait Domain of the Functional Evaluation Scale for Children with Duchenne Muscular Dystrophy.

AIM: To determine the responsiveness of functional gait assessment of children with Duchenne muscular dystrophy (DMD). METHOD: A total of 160 films of 32 children (mean age: 9.5 ± 2.7) with DMD were scored by the gait domain of the Functional Evaluation Scale - DMD. Children were recorded every 3 months for 1 year (0, 3, 6, 9, and 12 months). Responsiveness was analyzed by the effect sizes (ES) and standardized response means (SRM). RESULTS: Responsiveness was low to moderate at the 3-month interval (ES 0.12 to 0.34; SRM 0.27 to 0.80); low to high at the 6-month interval (ES 0.36 to 0.72; SRM 0.37 to 1.10); moderate to high at the 9-month interval (ES 0.70 to 1.0; SRM 0.50 to 1.43), and it was high at the 12-month interval (ES 0.74 to 1.34; SRM 0.88 to 1.53). CONCLUSION: Functional gait assessment of children with DMD was responsive since 3-month intervals. Responsiveness increased as reassessment intervals got longer. The highest responsiveness was observed when children were reevaluated after 12 months. The use of the gait domain of the Functional Evaluation Scale - DMD is recommended in 6- to 12-month intervals, which showed moderate to high responsiveness.

Contributions of the Left and the Right Hemispheres on Language-Induced Grip Force Modulation of the Left Hand in Unimanual Tasks.

Background andObjectives: Language-induced grip force modulation (LGFM) can be used to better understand the link between language and motor functions as an expression of embodied language. However, the contribution of each brain hemisphere to LGFM is still unclear. Using six different action verbs as stimuli, this study evaluated the grip force modulation of the left hand in a unimanual task to characterize the left and right hemispheres' contributions. Materials and Methods: Left-hand LGFM of 20 healthy and consistently right-handed subjects was evaluated using the verbs "to write", "to hold", "to pull" (left-lateralized central processing actions), "to draw", "to tie", and "to drive" (bihemispheric central processing actions) as linguistic stimuli. The time between the word onset and the first interval of statistical significance regarding the baseline (here as reaction time, RT) was also measured. Results: The six verbs produced LGFM. The modulation intensity was similar for the six verbs, but the RT was variable. The verbs "to draw", "to tie", and "to drive", whose central processing of the described action is bihemispheric, showed a longer RT compared to the other verbs. Conclusions: The possibility of a given manual action being performed by the left hand in consistent right-handers does not interfere with the occurrence of LGFM when the descriptor verb of this action is used as a linguistic stimulus, even if the possibility is remote. Therefore, LGFM seems to mainly rely on the left hemisphere, while a greater activation of the right hemisphere in action processing appears to slow the increase in LGFM intensity.

Association between educational status and dual-task performance in young adults.

The influence of educational status on perceptual-motor performance has not been investigated. The single- and dual-task performances of 15 Low educated adults (9 men, 6 women; M age=24.1 yr.; 6-9 yr. of education) and 15 Higher educated adults (8 men, 7 women; M age=24.7 yr.; 10-13 yr. of education) were compared. The perceptual task consisted of verbally classifying two figures (equal or different). The motor task consisted of alternating steps from the floor to a stool. Tasks were assessed individually and simultaneously. Two analyses of variance (2 groups×4 blocks) compared the errors and steps. The Low education group committed more errors and had less improvement on the perceptual task than the High education group. During and after the perceptual-motor task performance, errors increased only in the Low education group. Education correlated to perceptual and motor performance. The Low education group showed more errors and less step alternations on the perceptual-motor task compared to the High education group. This difference on the number of errors was also observed after the dual-task, when the perceptual task was performed alone.

Balance as an Additional Effect of Strength and Flexibility Aquatic Training in Sedentary Lifestyle Elderly Women.

OBJECTIVE: To evaluate the additional effects of on balance an aquatic muscle strengthening and flexibility training program in healthy sedentary lifestyle elderly women. METHOD: This controlled clinical trial included 56 healthy sedentary women, aged from 65 to 70 years, divided into two groups. The aquatic group (AG) underwent aquatic training (45 minutes/session, 32 sessions), and the control group (CG) received no intervention. Data were collected pre- and post-intervention, during a one-week period. Lower limb muscle strength was measured by a force sensor (myometer). Flexibility was measured by biophotogrammetry. Functional balance was evaluated by the Performance Oriented Mobility Assessment (POMA) and the Berg Balance Scale (BBS). RESULTS: Muscle strength, flexibility, and balance improved in AG (p < 0.001), but not in CG. CONCLUSION: The aquatic exercises program, which was originally developed to promote muscle strength and flexibility, also improved functional balance. Aquatic training is an option for physical health promotion for sedentary lifestyle elderly women.

Timed immersion expiration measures in patients with muscular dystrophies.

INTRODUCTION: Muscular dystrophies (MD) cause muscle weakness, affecting motor and respiratory functions. Aquatic activities maintain strength and ventilatory function and may require immersion expiration control. OBJECTIVES: (1) To describe the evolution of timed immersion expiration in patients with MD in one-year follow-up. (2) to describe motor and respiratory outcomes in one-year follow-up. (3) to investigate possible relationships between timed immersion expiration and age, motor and respiratory functions. METHOD: Fifty-seven patients with MD (12-35 years, Vignos scale 2-8) were evaluated twice, with one-year interval. Immersion expiration control was timed with a chronometer. Motor function was assessed by Motor Function Measure. The respiratory function was evaluated by spirometry. Analysis of variance compared assessments and Pearson tests investigated relationships between variables and age. RESULTS: Motor and respiratory functions decreased (p < 0.001) but timed immersion expiration was maintained. Timed immersion expiration was not correlated to motor and respiratory functions. CONCLUSION: As patients maintained timed immersion expiration in the one-year follow-up, aquatic therapy might be a facilitator for people with MD.

Functional performance and muscular strength in symptomatic female carriers of Duchenne muscular dystrophy.

Duchenne muscular dystrophy (DMD) usually affects men. However, women are also affected in rare instances. Approximately 8% of female DMD carriers have muscle weakness and cardiomyopathy. The early identification of functional and motor impairments can support clinical decision making. OBJECTIVE: To investigate the motor and functional impairments of 10 female patients with dystrophinopathy diagnosed with clinical, pathological, genetic and immunohistochemical studies. METHODS: A descriptive study of a sample of symptomatic female carriers of DMD mutations. The studied variables were muscular strength and functional performance. RESULTS: The prevalence was 10/118 (8.4%) symptomatic female carriers. Deletions were found in seven patients. The age of onset of symptoms in female carriers of DMD was quite variable. Pseudohypertrophy of calf muscles, muscular weakness, compensatory movements and longer timed performance on functional tasks were observed in most of the cases. Differently from males with DMD, seven female patients showed asymmetrical muscular weakness. The asymmetric presentation of muscle weakness was frequent and affected posture and functionality in some cases. The functional performance presents greater number of compensatory movements. Time of execution of activities was not a good biomarker of functionality for this population, because it does not change in the same proportion as the number of movement compensations. CONCLUSION: Clinical manifestation of asymmetrical muscle weakness and compensatory movements, or both can be found in female carriers of DMD mutations, which can adversely affect posture and functional performance of these patients.

Analysis of Different Device Interactions in a Virtual Reality Task in Individuals With Duchenne Muscular Dystrophy-A Randomized Controlled Trial.

There is a need to support individuals with Duchenne Muscular Dystrophy (DMD) to achieve optimal functionality in everyday life and with meaningful tasks and activities, throughout stages of the disease progression. Thus, technological developments have created an exciting opportunity for the use of affordable virtual reality (VR) systems with different kinds of interaction devices, providing an efficient and fun tool for enabling improvement in motor performance. Objective: To compare performance on a virtual task using interfaces with and without physical contact in order to identify functionality by using different devices in individuals with DMD. Methods: One hundred and twenty male individuals took part on this study: 60 with DMD with a mean age of 16 ± 5 (range 9-34 years old) and 60 without DMD in the control group (CG) matched by age. Participants were divided into three groups of 20 individuals each which performed a virtual task in three different interfaces: Kinect®, computer Touch Screen and Leap Motion®, in a cross over design in which all participants used all devices. Motor impairment in the DMD group was measured by using the Motor Function Measurement and Vignos scales. Results: All participants improved performance through practice, regardless of the interface used, although the DMD group had a continuous lower performance compared to the CG. In addition, the DMD group obtained a significant better performance with Leap Motion interface compared to the other interfaces, while the CG presented better performance on Touch Screen interface. Conclusion: Leap Motion provided better performance for individuals with DMD due to enablement of distal muscle function and ease of instrument adjustment using the virtual interface. Therefore, this type of interface should be encouraged for promoting functionality on general tasks using computer systems. Clinical Trial register number: NCT02891434.

Cognitive performance of children with spinal muscular atrophy: A systematic review.

Spinal muscular atrophy (SMA) is genetic and progressive, caused by large bi-allelic deletions in the SMN1 gene, or the association of a large deletion and a null variant. OBJECTIVE: To evaluate the evidence about cognitive outcomes in spinal muscular atrophy (SMA). METHODS: Searches on the PUBMED/Medline, Web of Knowledge and Scielo databases retrieved 26 studies (1989 to 2019, descriptors "spinal muscular atrophy" and "cognition"). Nine studies were selected according to the eligibility criteria: (1) cognition tested in individuals with SMA; (2) written in English or Spanish. The Risk of Bias in Non-Randomized Studies of Interventions was used to describe design, bias, participants, evaluation protocol and main findings. This study was registered on the International prospective register of systematic reviews (PROSPERO). RESULTS: Three studies described normal cognition. In another three studies, cognitive outcomes were above average. Cognitive impairment was found in three studies. Poor cognitive performance was more frequently reported in studies that were recent, included children with SMA type I and that employed visual/auditory attention and executive function tests. Protocols and cognitive domains varied, precluding metanalysis. CONCLUSION: The severity of motor impairment may be related to cognitive outcomes: studies that included a higher number/percentage of children with SMA type I found cognitive impairment. The establishment of gold-standard protocols is necessary. Further studies should compare the cognitive outcomes of subjects with SMA types I to IV.

A atrofia muscular espinhal (SMA) é genética e progressiva, causada por grandes deleções bi-alélicas no gene SMN1, ou pela associação de uma grande deleção e uma variante nula. OBJETIVO: Avaliar as evidências sobre o desempenho cognitivo na atrofia muscular espinhal (AME). MÉTODOS: Pesquisas nas bases de dados PUBMED/ Medline, Web of Knowledge e Scielo localizaram 26 estudos (1989 a 2019, descritores "atrofia muscular espinhal" e "cognição"). Nove estudos foram selecionados de acordo com os critérios de elegibilidade: (1) testaram a cognição em pessoas com AME; (2) escritos em inglês/espanhol. A avaliação do risco de viés em estudos com intervenções não-randomizadas foi utilizada para descrever o desenho experimental, viés, amostra, protocolo de avaliação e principais achados. Este estudo foi aprovado no Registro Internacional Prospectivo de Revisões Sistemáticas (PROSPERO). RESULTADOS: Em três estudos, foi registrado que a cognição estava preservada. Em três estudos, o desempenho cognitivo estava acima da média. O comprometimento cognitivo foi encontrado em três estudos. Desempenho cognitivo pobre foi mais frequentemente relatado em estudos recentes, estudos que incluíram crianças com AME tipo I e estudos que incluíram atenção visual/auditiva e testes de função executiva. Protocolos e domínios cognitivos variaram muito, portanto não foi possível a realização de metanálise. CONCLUSÃO: A gravidade do comprometimento motor pode estar relacionada ao desempenho cognitivo: estudos que incluíram maior número/porcentagem de crianças com AME tipo I encontraram alterações no desempenho cognitivo. O estabelecimento de protocolos padrão-ouro é necessário. Novos estudos devem comparar o desempenho cognitivo de pessoas com AME tipos I a IV, ou seja, com diferenças no prognóstico e no desempenho motor.

Manual action verbs modulate the grip force of each hand in unimanual or symmetrical bimanual tasks.

Manual action verbs modulate the right-hand grip force in right-handed subjects. However, to our knowledge, no studies demonstrate the ability to accomplish this modulation during bimanual tasks nor describe their effect on left-hand behavior in unimanual and bimanual tasks. Using load cells and word playlists, we evaluated the occurrence of grip force modulation by manual action verbs in unimanual and symmetrical bimanual tasks across the three auditory processing phases. We found a significant grip force increase for all conditions compared to baseline, indicating the occurrence of modulation. When compared to each other, the grip force variation from baseline for the three phases of both hands in the symmetrical bimanual task was not different from the right-hand in the unimanual task. The left-hand grip force showed a lower amplitude for auditory phases 1 and 2 when compared to the other conditions. The right-hand grip force modulation became significant from baseline at 220 ms after the word onset in the unimanual task. This moment occurred earlier for both hands in bimanual task (160 ms for the right-hand and 180 for the left-hand). It occurred later for the left-hand in unimanual task (320 ms). We discuss the hypothesis that Broca's area and Broca's homologue area likely control the left-hand modulation in a unilateral or a bilateral fashion. These results provide new evidence for understanding the linguistic function processing in both hemispheres.

Boys With Duchenne Muscular Dystrophy: 1-Year Locomotor Changes in Relation to a Control Group.

We compared the timed performance and compensatory movements of 32 boys (mean age = 10.0 years) with Duchenne muscular dystrophy (DMD) and 38 healthy boys (mean age = 9.2 years) on 10 -meter walking and four-step stair work (climbing and descending). Dependent measures were digital scores on the Functional Evaluation Scale for DMD obtained by watching the boys on film. Groups were compared initially and after 6 and 12 months, using General Linear Models analysis (for two groups and three assessments). Results showed no significant timed performance differences between groups on 10 -m walking at the initial assessment; but boys with DMD showed longer times after 6 and 12 months, and boys with DMD engaged in more compensatory movements while walking. For stair climbing, boys with DMD were significantly slower than healthy controls when both climbing and descending steps in all assessments.

Reliability, validity and description of timed performance of the Jebsen-Taylor Test in patients with muscular dystrophies.

BACKGROUND: The Jebsen-Taylor Test evaluates upper limb function by measuring timed performance on everyday activities. The test is used to assess and monitor the progression of patients with Parkinson disease, cerebral palsy, stroke and brain injury. OBJECTIVES: To analyze the reliability, internal consistency and validity of the Jebsen-Taylor Test in people with Muscular Dystrophy and to describe and classify upper limb timed performance of people with Muscular Dystrophy. METHODS: Fifty patients with Muscular Dystrophy were assessed. Non-dominant and dominant upper limb performances on the Jebsen-Taylor Test were filmed. Two raters evaluated timed performance for inter-rater reliability analysis. Test-retest reliability was investigated by using intraclass correlation coefficients. Internal consistency was assessed using the Cronbach alpha. Construct validity was conducted by comparing the Jebsen-Taylor Test with the Performance of Upper Limb. RESULTS: The internal consistency of Jebsen-Taylor Test was good (Cronbach's α=0.98). A very high inter-rater reliability (0.903-0.999), except for writing with an Intraclass correlation coefficient of 0.772-1.000. Strong correlations between the Jebsen-Taylor Test and the Performance of Upper Limb Module were found (rho=-0.712). CONCLUSION: The Jebsen-Taylor Test is a reliable and valid measure of timed performance for people with Muscular Dystrophy.

Effect of therapeutic Swedish massage on anxiety level and vital signs of Intensive Care Unit patients.

OBJECTIVE: To evaluate how Swedish massage affects the level of anxiety and vital signs of Intensive Care Unit (ICU) patients. METHODS: Quasi-experimental study. INCLUSION CRITERIA: ICU patients, 18-50 years old, cooperative, respiratory and hemodynamic stable, not under invasive mechanical ventilation. EXCLUSION CRITERIA: allergic to massage oil, vascular or orthopedic post-operative, skin lesions, thrombosis, fractures. A 30-min Swedish massage was applied once. VARIABLES: arterial pressure, heart rate, respiratory rate, S-STAI questionnaire. Timing of evaluation: pre-massage, immediately post-massage, 30 min post-massage. Comparison: T-test, corrected by Bonferroni method, level of significance of 5%, confidence interval of 95%. RESULTS: 48 patients included, 30 (62.5%) female, mean age 55.46 (15.70) years old. Mean S-STAI pre-massage: 42.51 (9.48); immediately post-massage: 29.34 (6.37); 30 min post-massage: 32.62 (8.56), p < 0.001 for all comparison. Mean vital signs achieved statistical significance between pre-massage and immediately post-massage. CONCLUSION: Swedish massage reduced anxiety of ICU patients immediately and 30 min post-massage. Vital signs were reduced immediately post-massage.

Massage and Storytelling Reduce Aggression and Improve Academic Performance in Children Attending Elementary School.

BACKGROUND: Aggressive behaviors must be addressed in elementary schools. Massage and storytelling can be strategies to deal with aggression because both involve experience exchange and social interaction. Both can decrease stress and anxiety and increase self-esteem. OBJECTIVE: To evaluate the effect of two interventions (massage and storytelling) on aggressive behaviors and academic performance of elementary school children. METHOD: Three groups (n = 35 children in each group) of the second grade participated (aged 6.5-8.1 years). One group received ten extra classes of massage (MG), another group received extra classes of storytelling (SG), and the control group received extra classes of random subjects (CG). Extra classes lasted for 50 minutes, once a week. Aggressive behaviors were recorded on diaries, by the teachers and the coordinator. The frequency of aggressive behaviors and the academic performance of MG, SG, and CG were observed for six months and the groups were compared. FINDINGS: ANOVAs evidenced that MG and SG, but not CG, showed a reduction in aggressive behaviors registered by the teachers and coordinator, after the intervention. Academic performance of MG and SC improved after the intervention (p < 0.05).

Epidemiological and clinical factors impact on the benefit of riluzole in the survival rates of patients with ALS.

OBJECTIVE: To investigate the impact of epidemiological and clinical factors on the benefit of riluzole in patients with amyotrophic lateral sclerosis (ALS). METHODS: The survival rate of 578 patients with ALS (1999-2011) was analyzed by descriptive statistics and Kaplan-Meier curves. Considering the median of the sample survival time (19 months), patients were divided in two groups: below (B19) and above the median (A19). Kaplan-Meier curves compared the survival rates of patients treated with riluzole and with patients who did not take the medication. RESULTS: Riluzole increased the survival rates of patients with lower limb onset who were diagnosed after the first appointment in B19. Patients with bulbar onset and diagnosed on the first, or after the first appointment showed higher survival rates in A19. Males lived longer than females in both groups. CONCLUSION: Epidemiological and clinical factors influenced the benefit of riluzole in the survival rates of patients with ALS.

Application and outcomes of therapy combining transcranial direct current stimulation and virtual reality: a systematic review.

PURPOSE: To evaluate the methods and major outcomes of transcranial direct current stimulation (tDCS) combined with virtual reality (VR) therapy in randomized controlled trials. METHOD: A systematic review was performed following PRISMA guidelines using PubMed, PubMed Central, Web of Science and CAPES periodic databases, with no time restriction. The studies were screened for the following inclusion criteria: human subjects, combination of VR and tDCS methods, and randomized controlled study design. All potentially relevant articles were independently reviewed by two researchers, who reached a consensus on which articles met the inclusion criteria. The PEDro scale was used to evaluate the studies. RESULTS: Eleven studies were included, all of which utilized a variety of tDCS and VR application methods. The main outcomes were found to be beneficial in intervention groups of different populations, including improvements in body sway, gait, stroke recovery, pain management and vegetative reactions. CONCLUSIONS: The use of tDCS combined with VR showed positive results in both healthy and impaired patients. Future studies with larger sample sizes and homogeneous participants are required to confirm the benefits of tDCS and VR. Implications for Rehabilitation tDCS with VR intervention can be an alternative to traditional rehabilitation programs. tDCS with VR is a promising type of intervention with a variety of positive effects. Application of tDCS with VR is appropriated to both healthy and impaired patients. There is no consensus of tDCS with VR application.

Educational status influences cognitive-motor learning in older adults: going to university provides greater protection against aging than going to high school.

OBJECTIVE: To investigate if middle-aged and older adults with a higher education would differ from those with an average education in cognitive-motor tasks involving lower limb function. METHODS: A walking version of the Trail Making Test (Walking Executive Function Task, [WEFT]) was used. Eighty volunteers (40: 50-65 years; 40: 66-80 years) were subdivided into average (6-11years of education) and higher education (12-17 years). They received two training sessions (session 1: eight repetitions, session 2: four repetitions), with a one week-interval between them. The Timed Up and Go (TUG) test was performed before and after the training. RESULTS: Volunteers with an average education showed longer times on the WEFT than those with a higher education. Older adults showed lower retention than middle-aged adults (p < 0.001). The TUG was faster after the WEFT training (p < 0.001). CONCLUSION: The impact of education was observed when locomotion was associated with cognitive tasks. Average education resulted in poorer performance and learning than higher education, mainly in older adults. Gait speed increased after training.

Matching pairs difficulty in children with spinal muscular atrophy type I.

This study aimed to investigate the performance on pair-matching tasks in children with Spinal Muscular Atrophy type I (SMA-I) and the relationship between this performance and motor function, functional independence and quality of life. SMA-I (n = 12; 6.0 ± 2.3 yrs; 9 boys, 3 girls) and control sex-, age-matched children (n = 12; 6.2 ± 2.6 yrs) performed four pair-matching figure, number and letter tasks. The eye tracker detected eye movements. SMA-I children were assessed with CHOP INTEND, Pediatric Evaluation of Disability Inventory, and Pediatric Quality of Life Inventory. Analysis of variance showed that SMA-I children had a lower percentage of correct answers and longer timed performance compared to controls (p < 0.05). Pediatric Evaluation of Disability Inventory score (social function domain) was correlated to the percentage of correct answers on the pair-matching tasks on task 1 (r = 0.81; p = 0.001) and task 2 (r = 0.66; p = 0.020). Pair-matching performance of SMA-I children was poorer than the performance of control children. There was a relationship between pair-matching performance and social function. The restricted interaction with the environment, due to severe paralysis and poor verbal communication, is associated with cognitive difficulties in SMA-I children. The eye tracker was helpful in cognitive assessment of SMA-I children, who responded to the cognitive tests with eye movements.

How often should sitting and rising from a chair be evaluated in patients with Duchenne muscular dystrophy?

OBJECTIVE: To determine how often sitting/rising from a chair should be assessed in Duchenne muscular dystrophy (DMD) patients to avoid redundant/missing data. METHODS: Sitting/rising from a chair was evaluated in 26 DMD children (5-12 yrs), in three-month intervals, over twelve months, with the Functional Evaluation Scale (domain sitting/rising from a chair). Scores were compared by effect sizes (ES) and standardized response means (SRM) (responsiveness analysis). RESULTS: Sit-to-stand showed low-to-moderate responsiveness in three-month intervals (ES:0.23-0.32; SRM:0.36-0.68), moderate-to-high responsiveness in six-month intervals (ES:0.52-0.65; SRM:0.76-1.28), high responsiveness at nine-month (ES:0.84-0.91; SRM:1.26-1.64) and twelve-month intervals (ES:1.27; SRM:1.48). Stand-to-sit showed low responsiveness in three-month intervals (ES:0.26-0.49; SRM:0.37-0.42), moderate responsiveness in six-month intervals (ES:0.50-0.78; SRM:0.56-0.71), high responsiveness in nine-month (ES:0.94-1.00; SRM:0.84-1.02) and twelve-month intervals (ES:1.13; SRM:1.52). CONCLUSION: Six months or longer intervals for reassessment are indicated to evaluate sitting/standing from a chair in DMD patients.

Caracterização da força e da função muscular nas disferlinopatias em amostra brasileira / Characterization of muscle strength and function in dysferlinopathy in a Brazilian sample

Estudo de caracterização da força e da função muscular nas disferlinopatias para estabelecer biomarcadores de habilidades motoras com amostra de 40 pacientes, tendo sido avaliados força muscular (Medical Research Council - MRC), percentual de MRC, tempo de execução para deambular e escores nas Escalas de Vignos, Egen Klassifikation, Avaliação Funcional para Distrofia Muscular de Duchenne (FES-DMD) e North Star Ambulatory Assessment adaptada. Prevalência da disferlinopatia de 25,5% na amostra total de distrofias (1340), idade média de 36,5 anos, 52,5% do sexo masculino e 75% deambuladores. Músculos mais fracos: abdominal, glúteos, íliopsoas, isquiotibial, quadríceps femoral, tibial anterior e deltoide médio. Correlação forte entre MRC e tempo para deambular (r = 0,77) e, muito forte da MRC distal de membros inferiores com aNSAA (r = 0,90). Interação da MRC dos membros superiores e inferiores nos segmentos proximal e distal (p < 0,001), sendo mais evidente em membros superiores que inferiores. Taxa variável de progressão da doença com 60% dos pacientes moderadamente ou gravemente afetados, com mais de 12 anos de doença. Estudo mostra que padrão de fraqueza muscular dos brasileiros com disferlinopatia é proximal e distal dos MMII, com comprometimento associado da região proximal dos MMSS, além de elucidar as habilidades motoras em relação ao processo de locomoção e disfunções cardiorrespiratórias. (AU).

Percepção de saúde, mobilidade e humor de mulheres participantes de caminhada em imersão / Perception of health, mobility and mood of women participating in immersion walk

Estudos têm demonstrado que exercícios realizados em meio aquático produzem benefícios diversos para mulheres. Esta pesquisa objetivou avaliar a percepção subjetiva de saúde, mobilidade e humor de mulheres quinquagenárias saudáveis e sedentárias em decorrência de participação em programa de caminhada em imersão. Participaram 59 mulheres entre 50 e 59 anos, distribuídas em grupos de 10 a 12 pessoas. A atividade foi desenvolvida em piscina aquecida 2 vezes por semana, por 30 minutos, durante 12 meses. O programa foi dividido em 4 etapas de 3 meses com 5 tempos de avaliação. Para a avaliação subjetiva sobre o estado de saúde, mobilidade e humor, utilizou-se uma escala numérica de 0 a 10. Breve relato sobre os principais efeitos do programa também foi analisado em seu conteúdo. Observou-se melhora na percepção de saúde (p < 0,001), na mobilidade (p < 0,001) e no humor (p = 0,003). Na análise de conteúdo, 49,4% dos relatos relacionaram-se com a melhora da saúde; 22,9% com a autoestima e satisfação e 19,3% com a capacidade física. O estudo reforça a necessidade deste tipo de prática para a saúde integral da mulher de "meia idade" como medida preventiva do processo de envelhecimento saudável. (AU)