Assessment of functional mobility and gait during a timed up and go test in adults with total blindness.

BACKGROUND: The loss of vision leads to behavioral and motor adaptations that do not necessarily translate to good functioning with regards to daily tasks. AIM: To investigate differences in functional mobility in adults with total blindness, and analyze differences in spatiotemporal gait variables with and without the use of a cane, and wearing shoes or barefoot. METHODS: We used an inertial measurement unit to assess the spatiotemporal parameters of the gait and functional mobility in seven subjects with total blindness and four sighted participants during the timed up and go test (TUG) test performed under conditions: barefoot/shod; and with/without a cane (blind subjects). RESULTS: Significant differences between groups were found in total TUG test time and in the sub-phases when the blind subjects executed the TUG barefoot and without a cane (p < .01). Other differences were found in trunk movement during sit-to-stand, and stand-to-sit where blind subjects when without cane and barefoot, they had a greater range of motion than sighted subjects (p < .01). Also, BMI has a moderate to strong influence in the execution of the TUG in blind subjects (p < .05) CONCLUSION: This study showed that, when using a gait-assistance device and wearing shoes, blind subjects have similar functional mobility and gait as sighted subjects, suggesting that an external haptic reference can compensate for the lack of vision. Knowledge of these differences can provide a better understanding of the adaptive behavior in this population, thereby assisting in minimizing the occurrence of trauma and falls.

Use of wearable inertial sensors for the assessment of spatiotemporal gait variables in children: A systematic review

Abstract Aim: The present study aimed to perform a literature review on the use of wearable inertial sensors for gait analysis of children in clinical practice. Methods: Searches were performed in the MEDLINE, EMBASE, Cochrane Library, and PEDro databases for studies involving children or adolescents submitted to gait analysis with the use of wearable inertial sensors. No restrictions were imposed regarding the date of publication or language. Results: Three hundred twenty articles were retrieved, 14 of which met the eligibility criteria and were selected for the present systematic review. Two independent reviewers assessed the risk of bias and study quality using the ROBINS-I and AXIS scale. The studies included in the present review reported multiple outcomes of kinematic gait assessments calculated from the signals provided by the wearable sensors, performed in a hospital setting, outpatient clinic, and a familiar environment, with several types of pediatric conditions. Conclusion: The findings suggest that wearable sensors are effective for the evaluation of quantitative gait variables in children with different pediatric conditions, enabling an objective analysis that should prove useful in the processes of clinical diagnosis and rehabilitation. However, given the relatively small number of studies published on this topic, it is difficult to make strong recommendations regarding the most appropriate equipment, sensor placement, and outcomes for assessing gait in children.

Use of the Gait Deviation Index and spatiotemporal variables for the assessment of dual task interference paradigm.

Three-dimensional gait analysis (3DGA) is an important element in the quantitative evaluation of gait in subjects with Parkinson's disease (PD). Indexes, such as the Gait Deviation Index (GDI), have recently been proposed as a summary measure of gait. The aim of the present study was to investigate the effectiveness of the GDI and spatiotemporal variables in the quantification of changes in gait during a dual-task (DT) exercise. Fourteen patients with idiopathic PD and nine healthy subjects (CG) participated in the study. All subjects walked under two conditions: free walking and DT walking. The GDI was computed from the 3DGA data. The results show gait impairment during DT, a significant difference between groups regarding GDI and an interaction effect involving the group, side and task factors. The CG and PDG were different independent of interference and side, but interference was only different for the PDG group. The results also demonstrate that the GDI should be an appropriate outcome measure for the evaluation of the effects of DT on patients with Parkinson's disease.

Avaliação do ácido lático em individuos com hemiparesia pós-acidente vascular encefálico após estimulação elétrica para fortalecimento muscular / Latic acid assessment in post-stroke hemiparetic subjects followung electrical stimulation for muscle strengthening

O fortalecimento da musculatura parética promove melhora da capacidade funcional, o que pode ser obtido pela estimulação elétrica funcional (EEF), porém são necessários parâmetros específicos para evitar fadiga muscular. Este estudo visou verificar, em indivíduos com hemiparesia pós-AVE, o tempo de repouso (time off) necessário para reabsorção do ácido lático durante a EEF, de modo a evitar a fadiga – detectada por lactacidemia (concentração excessiva de ácido lático). Foram coletadas amostras de sangue de 18 indivíduos portadores de hemiparesia em sete momentos, antes, durante e após a EEF. A corrente quadrada bifásica, de 50 Hz, foi usada com time on de 10 segundos (s) e o time off variou de 10 s (protocolo 1) a 30 s (protocolo 2), sobre o ponto motor do músculo tibial anterior. Na análise do sangue coletado, não foi encontrada diferença estatisticamente significante (p>0,05) entre os dois protocolos; tampouco foi registrada diferença no período imediatamente pós-terapia. Pode-se pois afirmar que a ferramenta utilizada para mensurar lactacidemia não se mostrou eficaz na detecção da fadiga muscular, inviabilizando verificar o tempo ideal de repouso (time off), sendo necessários mais estudos em busca de protocolos seguros. Sugere-se a continuidade deste estudo, com alteração do músculo e atividade funcional eliciada pela estimulação elétrica, bem como uma ferramenta alternativa na mensuração e detecção da fadiga muscular...

Strengthening paretic muscles improves functional capacity, which can be achieved by functional electric stimulation (FES), but specific parameters are needed in order to prevent muscle fatigue. The purpose of this study was to assess, in poststrokehemiparetic patients, the necessary time of rest (time off) for re-absorption of lactic acid during FES, so as to prevent fatigue – detected by lactic acid testing. Blood samples of 18 hemiparetic subjects were collected at seven moments: pretreatment rest, after each of three series of 15 repetitions stimuli, and at the third, sixth, and ninth minutes following therapy session. Electrical, two-phase pulses at 50 Hz were applied, 10 seconds on and 10 seconds off (protocol 1), and 10 seconds on and 30 seconds off (protocol 2), on the motor point of tibialis anterior muscle. The blood sample analysis showed no statistically significant differences (p>0.05) between protocols 1 and 2; neither could differences be found at immediate post session measures. It may thus be said that the measuring tool here employed to infer fatigue did not prove efficient to detect it, therefore preventing the assessment of the ideal time of rest (time off). Thus a continuity of this study is suggested, with changes in the muscle and the functional activity elicited by electric stimulation,and relying on an alternative tool for measuring and detecting muscle fatigue...

Avaliação do risco de desenvolver "pé diabético" em uma população de diabéticos do Centro de Saúde Ventosa em Belo Horizonte, MG / Assessment of the risk of developing diabetic foot in a population of diabetics from the Health Center Ventosa in Belo Horizonte, MG

O objetivo do presente estudo foi analisar o perfil dos diabéticos assistidos pelo Programa de Saúde da Família (PSF) no Centro de Saúde Ventosa em Belo Horizonte quanto ao risco de desenvolver Pé Diabético. A pesquisa foi um estudo descritivo no qual os sujeitos foram submetidos a uma avaliação do pé diabético em risco. Foram selecionados 33 diabéticos, (16 excluídos, destes, 12 por alteração cognitiva). Dos 17 avaliados, 12 eram mulheres e 5 homens; com idade (60, 58 + 9,93 anos) ; 15 DM 2 e 2 DM 1; e tempo diagnóstico (7 + 8, mediana 3 anos). Os diabéticos foram classificados quanto ao grau de risco do pé: 41% foram classificados como risco 0; 53% classificados como risco 2 e 6% apresentaram grau de risco 3. O risco de lesão no pé foi alto nos diabéticos avaliados, necessitando a implantação de medidas preventivas e terapêuticas especializadas.

The aim of the current study is to analyze the profile of diabetic patients assisted by the Family Health Program at the Health Center Ventosa in Belo Horizonte regarding their risk of developing Diabetic Foot. It is a descriptive study where the subjects underwent an evaluation of the endangered diabetic foot. 33 diabetic patients were selected (16 of them were excluded, 12 due to congnitive alteration). From the 17 patients evaluated, 12 were women and 5 men; with age 60,58 (+ 9,93) years old; 15 DM 2 and 2 DM 1; time of diagnosis 7 + 8 (median 3 years). The diabetic patients were classified according to the degree of foot risk, with 41% classified as 0 risk; 53% classified as risk 2 and 6% as risk 3. The risk of damage in the foot was high in the diabetic patients assessed, which will need specialized preventive and therapeutic measures.