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1.
Artigo em Inglês | MEDLINE | ID: mdl-25809192

RESUMO

Fibromyalgia (FM), clinical condition characterized by several signs and symptoms such as widespread pain, trigger point, morning stiffness and extreme tiredness for scarce hours of sleep, is linked to several changes in several brain neurotransmitters, particularly serotonin and norepinephrine. Consequently, the Neural Vegetative System works more and so it generates an exaggerated muscular contraction, sweating and constriction of blood vessels. The aim of our study was to treat a selected group of female patients suffering from FM with duloxetine with physiotherapy. We used two clinical scales (VAS and FIQ) and an objective evaluation such as myometric. The analysis of the data Myoton used during any inspection showed a statistically significant reduction in the values of muscle tone in each district analyzed. This finding was also confirmed by the patients themselves who have experienced a significant welfare and less muscle tension in different locations, as evidenced by data obtained from the clinical scales used by us. In addition, our patients were thought to be satisfied with the improvements not only subjective, but also with the objective witnessed myometry, making them a share of the study and feeling constantly monitored for treatment aimed at a real reduction in muscle stiffness. In conclusion, our study demonstrates combined treatment duloxetine- physiotherapy effectively reduces a symptom often disabling and particularly troublesome in patients with FM as the exaggerated muscle contraction.


Assuntos
Cloridrato de Duloxetina/uso terapêutico , Terapia por Exercício/métodos , Fibromialgia/diagnóstico , Fibromialgia/terapia , Músculo Esquelético/fisiologia , Reologia/métodos , Adulto , Analgésicos/uso terapêutico , Feminino , Fibromialgia/fisiopatologia , Humanos , Pessoa de Meia-Idade , Músculo Esquelético/efeitos dos fármacos , Inquéritos e Questionários , Resultado do Tratamento
2.
Res Dev Disabil ; 30(5): 1034-43, 2009.
Artigo em Inglês | MEDLINE | ID: mdl-19285830

RESUMO

Post-coma persons in an apparent condition of vegetative state and pervasive motor impairment pose serious problems in terms of assessment and intervention options. A technology-based learning assessment procedure might serve for them as a diagnostic supplement with possible implications for rehabilitation intervention. The learning assessment procedure adopted in this study relied on hand-closure and eye-blinking responses and on microswitch technology to detect such responses and to present stimuli. Three participants were involved in the study. The technology consisted of a touch/pressure sensor fixed on the hand or an optic sensor mounted on an eyeglasses' frame, which were combined with a control system linked to stimulus sources. The study adopted an ABABCB sequence, in which A represented baseline periods, B intervention periods with stimuli contingent on the responses, and C a control condition with stimuli presented non-contingently. Data showed that the level of responding during the B phases was significantly higher than the levels observed during the A phases as well as the C phase for two of the three participants (i.e., indicating clear signs of learning by them). Learning might be deemed to represent basic levels of knowledge/consciousness. Thus, detecting signs of learning might help one revise a previous diagnosis of vegetative state with wide implications for rehabilitation perspectives.


Assuntos
Coma/complicações , Estado Vegetativo Persistente/diagnóstico , Tecnologia Assistiva , Adulto , Idoso , Piscadela , Lesões Encefálicas/reabilitação , Auxiliares de Comunicação para Pessoas com Deficiência , Feminino , Força da Mão , Humanos , Masculino , Terapia Ocupacional/instrumentação , Estado Vegetativo Persistente/etiologia , Estado Vegetativo Persistente/reabilitação , Desempenho Psicomotor
3.
Brain Inj ; 23(2): 154-62, 2009 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-19191094

RESUMO

PRIMARY OBJECTIVE: Detecting signs of learning in persons with a diagnosis of post-coma vegetative state and profound motor disabilities could modify their diagnostic label and provide new hopes. In this study, three adults with such a diagnosis were exposed to learning assessment to search for those signs. PROCEDURE AND DESIGN: The assessment procedure relied on participants' eye-blinking responses and microswitch-based technology. The technology consisted of an electronically regulated optic microswitch mounted on an eyeglasses' frame that the participants wore during the study and an electronic control system connected to stimulus sources. Each participant followed an ABABCB design, in which A represented baseline periods, B intervention periods with stimuli contingent on the responses and C a control condition with stimuli presented non-contingently. MAIN OUTCOMES AND RESULTS: The level of responding during the B phases was significantly higher than the levels observed during the A phases as well as the C phase for all participants (i.e. indicating clear signs of learning by them). CONCLUSIONS: These findings may have important implications for (a) changing the participants' diagnostic label and offering them new programme opportunities and (b) including learning assessment within the evaluation package used for persons with post-coma profound multiple disabilities.


Assuntos
Piscadela/fisiologia , Coma/reabilitação , Estado Vegetativo Persistente/reabilitação , Pessoas com Deficiência Mental/reabilitação , Adulto , Idoso , Aprendizagem por Associação , Coma/diagnóstico , Coma/fisiopatologia , Auxiliares de Comunicação para Pessoas com Deficiência , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Estado Vegetativo Persistente/diagnóstico , Estado Vegetativo Persistente/fisiopatologia , Pessoas com Deficiência Mental/psicologia , Reprodutibilidade dos Testes
4.
Dev Neurorehabil ; 12(6): 411-20, 2009.
Artigo em Inglês | MEDLINE | ID: mdl-20205550

RESUMO

OBJECTIVE: To evaluate the viability of technology-assisted learning setups for undertaking assessment and providing intervention to persons in vegetative state. METHOD: Study I investigated whether three persons with a diagnosis of vegetative state could associate eye blinking or hand closure responses with contingent, positive stimulation, thus increasing their frequencies (showing signs of learning). Study II extended the learning process (introducing a new response and new stimuli) for one of the participants of Study I. RESULTS: Two of the participants of Study I succeeded in increasing their responses, indicating signs of learning. Study II showed that the participant (one of the two succeeding in Study I) acquired a new response to access new stimuli and could alternate this response with the one acquired in Study I. CONCLUSION: Learning might represent a basic level of knowledge and consciousness. Detecting signs of learning might help modify a previous diagnosis of vegetative state and support intervention/rehabilitation efforts.


Assuntos
Lesões Encefálicas/reabilitação , Auxiliares de Comunicação para Pessoas com Deficiência , Aprendizagem , Estado Vegetativo Persistente , Tecnologia Assistiva , Acidentes de Trânsito , Adolescente , Adulto , Idoso , Piscadela/fisiologia , Lesões Encefálicas/fisiopatologia , Coma/fisiopatologia , Estado de Consciência/fisiologia , Eletroencefalografia , Feminino , Força da Mão/fisiologia , Humanos , Masculino , Afogamento Iminente
5.
Res Dev Disabil ; 29(4): 373-84, 2008.
Artigo em Inglês | MEDLINE | ID: mdl-17681451

RESUMO

A program relying on microswitch clusters (i.e., combinations of microswitches) and preferred stimuli was recently developed to foster adaptive responses and head control in persons with multiple disabilities. In the last version of this program, preferred stimuli (a) are scheduled for adaptive responses occurring in combination with head control (i.e., head upright) and (b) last through the scheduled time only if head control is maintained for that time. The first of the present two studies was aimed at replicating this program with three new participants with multiple disabilities adding to the three reported by Lancioni et al. [Lancioni, G. E., Singh, N. N., O'Reilly, M. F., Sigafoos, J., Didden, R., Oliva, D., et al. (2007). Fostering adaptive responses and head control in students with multiple disabilities through a microswitch-based program: Follow-up assessment and program revision. Research in Developmental Disabilities, 28, 187-196]. The second of the two studies served to carry out an expert validation of the program's effects on head control and general physical condition with the three participants of Study I as well as the three participants involved in the Lancioni et al. study mentioned above. The expert raters were 72 new physiotherapists and 72 experienced physiotherapists. The results of Study I supported previous data and indicated that the program was effective in helping the participants increase the frequency of adaptive responses in combination with head control and the length of such control. The results of Study II showed that the raters found the effects of the new program more positive than those of other intervention conditions and also considered such program a useful complement to formal motor rehabilitation programs.


Assuntos
Deficiências do Desenvolvimento/reabilitação , Deficiências do Desenvolvimento/terapia , Movimentos da Cabeça , Modalidades de Fisioterapia/instrumentação , Adaptação Fisiológica , Adolescente , Criança , Deficiências do Desenvolvimento/complicações , Feminino , Humanos , Deficiência Intelectual/complicações , Deficiência Intelectual/reabilitação , Deficiência Intelectual/terapia , Masculino , Atividade Motora , Postura , Desempenho Psicomotor , Reprodutibilidade dos Testes , Tecnologia Assistiva , Inquéritos e Questionários , Gravação de Videoteipe
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