ABSTRACT
(1) Background: Stroke is one of the leading causes of disability. To identify the best treatment strategies for people with stroke (PwS), the aim of the current study was to compare the effects of training on a treadmill with functional electrical stimulation (TT-FES) with training on a treadmill (TT), and to analyze the effects of sequence of training on mobility and the parameters of walking ability. (2) Methods: Prospective, longitudinal, randomized and crossover study, in which 28 PwS were distributed into groups, namely the A-B Group (TT-FES followed by TT) and B-A Group (TT followed by TT-FES), using the foot drop stimulator, and were measured with functional tests. (3) Results: We found improved mobility, balance, non-paretic limb coordination, and endurance only in the group that started with TT-FES. However, sensorimotor function improved regardless of the order of training, and paretic limb coordination only improved in the B-A Group, but after TT-FES. These data indicate that the order of the protocols changed the results. (4) Conclusions: Although biomechanical evaluation methods were not used, which can be considered a limitation, our results showed that TT-FES was superior to isolated training on a treadmill with regard to balance, endurance capacity, and coordination of the non-paretic limb.
Subject(s)
Electric Stimulation Therapy , Gait Disorders, Neurologic , Stroke Rehabilitation , Stroke , Humans , Gait/physiology , Cross-Over Studies , Prospective Studies , Electric Stimulation Therapy/methods , Stroke/therapy , Electric Stimulation , Gait Disorders, Neurologic/etiology , Gait Disorders, Neurologic/therapyABSTRACT
Abstract Introduction Since social isolation during the COVID-19 pandemic can influence a patient's and informal caregiver's health, the present study was carried out to understand and improve the latter's quality of life. Objective To analyze the physical, mental and quality of life effects on caregivers of patients with neurological sequelae and developmental delay during the COVID-19 pandemic. Methods: Thirty informal caregivers divided into two groups (G1: Psychomotor disorders and syndromes; G2: Neurological sequelae) were evaluated using questionnaires on general data, burden and quality of life. Chi-square tests with Bonferroni post-hoc correction were performed to compare the response rate between the dependent variables and the level of burden. The student's t-test was applied to determine the correlation between groups and quality of life, obtaining significant findings (p ≤ 0.05). Results No or minimal burden was found in 33.3% of the caregivers, and mild to moderate in 66.7% of each group, with no significant effect between them. In terms of quality of life, a decline was found in all domains, with a significant intergroup difference in social aspects and G1 exhibiting the highest declines (G1: 70.00 ± 23.99%; G2: 86.66 ± 20.84%). Conclusion There was a mild-to-moderate impact on physical burden, with a change in the quality of life of caregivers evaluated during the COVID-19 pandemic. Caregivers of children with psychomotor disorders and syndromes were the most affected in the social aspect domain.
Resumo Introdução O isolamento social durante a pandemia de COVID-19 pode influenciar a saúde do paciente e do cuidador informal. No intuito de compreender e orientar a melhora da qualidade de vida destes cuidadores, este estudo foi realizado. Objetivo Analisar os efeitos físicos, mentais e a qualidade de vida de cuidadores de pacientes com sequelas neurológicas e atraso do desenvolvimento durante a pandemia de COVID-19. Métodos Trinta cuidadores informais divididos em dois grupos (G1: distúrbios psicomotores e síndromes; G2: sequelas neurológicas) foram avaliados com questionários sobre dados gerais, sobrecarga e qualidade de vida. Foram realizados os testes qui-quadrado com pós-teste de Bonferroni para comparar a taxa de resposta entre as variáveis dependentes e o nível de sobrecarga. Para a correlação entre os grupos e a qualidade de vida, utilizou-se o teste t de Student não pareado, sendo significativo os achados com p ≤ 0,05. Resultados Encontrou-se ausência de sobrecarga ou sobrecarga mínima em 33,3% e sobrecarga leve a moderada em 66,7% dos cuidadores em cada grupo, sem efeito significativo entre estes. Na qualidade de vida foi encontrado déficit em todos os domínios, com diferença significativa entre os grupos no domínio de aspectos sociais, tendo o G1 apresentado maiores déficits (G1: 70,00 ± 23,99%; G2: 86,66 ± 20,84%). Conclusão Conclui-se que houve impacto de leve a moderado na sobrecarga física, com alteração na qualidade de vida dos cuidadores avaliados durante a pandemia de COVID-19, sendo os cuidadores de crianças com distúrbios psicomotores e síndromes os mais acometidos no aspecto social.
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Individuals with Duchenne Muscular Dystrophy (DMD) have an impairment of cardiac autonomic function categorized by parasympathetic reduction and sympathetic predominance. The objective of this study was to assess the cardiac autonomic modulation of individuals with DMD undergoing therapy with Prednisone/Prednisolone and Deflazacort and compare with individuals with DMD without the use of these medications and a typically developed control group. Methods: A cross-sectional study was completed, wherein 40 boys were evaluated. The four treatment groups were: Deflazacort; Prednisone/Prednisolone; no corticoid use; and typical development. Heart Rate Variability (HRV) was investigated via linear indices (Time Domain and Frequency Domain) and non-linear indices Results: The results of this study revealed that individuals with DMD undertaking pharmacotherapies with Prednisolone demonstrated HRV comparable to the Control Typically Developed (CTD) group. In contrast, individuals with DMD undergoing pharmacotherapies with Deflazacort achieved lower HRV, akin to individuals with DMD without any medications, as demonstrated in the metrics: RMSSD; LF (n.u.), HF (n.u.), LF/HF; SD1, α1, and α1/α2, and a significant effect for SD1/SD2; %DET and Ratio; Shannon Entropy, 0 V%, 2 LV% and 2 ULV%. Conclusions: Corticosteroids have the potential to affect the cardiac autonomic modulation in adolescents with DMD. The use of Prednisone/Prednisolone appears to promote improved responses in terms of sympathovagal activity as opposed to Deflazacort.
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OBJECTIVES: Sensory and motor alterations resulting from stroke often impair the performance and learning of motor skills. The present study is aimed at investigating whether and how poststroke individuals and age- and sex-matched healthy controls benefit from a contextual interference effect on the practice of a maze task (i.e., constant vs. random practice) performed on the computer. METHODS: Participants included 21 poststroke individuals and 21 healthy controls, matched by sex and age (30 to 80 years). Both groups were divided according to the type of the practice (constant or random) presented in the acquisition phase of the learning protocol. For comparison between the groups, types of practice, and blocks of attempts, the analysis of variance with Tukey's post hoc test (p < 0.05) was used. RESULTS: Poststroke individuals presented longer movement times as compared with the control group. In addition, only poststroke individuals who performed the task with random practice showed improved performance at the transfer phase. Moreover, randomized practice enabled poststroke individuals to perform the transfer task similarly to individuals without any neurological impairment. CONCLUSION: The present findings indicated a significant effect of contextual interference of practice in poststroke individuals, suggesting that applying randomized training must be considered when designing rehabilitation protocols for this population.
Subject(s)
Learning/physiology , Motor Skills/physiology , Movement/physiology , Stroke/physiopathology , Adult , Aged , Aged, 80 and over , Computers , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Stroke Rehabilitation/methods , Task Performance and AnalysisABSTRACT
The Stroke might cause alterations in movement control due to the sequels of this process. Objective: Analyze the speed-accuracy trade-off of upper limb movement in individuals with sequels of Stroke through a computer software. Method: It is about a cross-sectional study, the sample was composed of 46 individuals divided into two groups: individuals post-stroke, between the ages of 35 and 83 years old, in which 10 were women and 14 were men; and 22 healthy controls aligned by age and sex, in which 8 were women and 14 were men, evaluated through the instruments: Mini mental state examination, Orpington prognostic scale, Fugl-Meyer Assessment Scale, dynamometer, box of blocks and throught the software "Fitts Reciprocal Aiming Task v.2.0. (Horizontal)", that seeks to understand the motor control of the upper limb, verifying the speed and accuracy of movement through a computer task. Results: The individuals with sequels of Stroke showed a loss in the strength of the palmar grip and manual function. Besides, they showed a longer time in movement in all index of difficulty compared to Control group. However, they showed a similar behaviour to the healthy individuals throughout the execution of the index of difficulty. Conclusion: Thus, it can be concluded that the individuals with sequels of Stroke showed a deficit of the motor control of the upper limb, compared to the healthy individuals, however, these showed the same behavior, with a bigger deficit in the accuracy of movement
The Stroke might cause alterations in movement control due to the sequels of this process. Objective: Analyze the speed-accuracy trade-off of upper limb movement in individuals with sequels of Stroke through a computer software. Method: It is about a cross-sectional study, the sample was composed of 46 individuals divided into two groups: individuals post-stroke, between the ages of 35 and 83 years old, in which 10 were women and 14 were men; and 22 healthy controls aligned by age and sex, in which 8 were women and 14 were men, evaluated through the instruments: Mini mental state examination, Orpington prognostic scale, Fugl-Meyer Assessment Scale, dynamometer, box of blocks and throught the software "Fitts Reciprocal Aiming Task v.2.0. (Horizontal)", that seeks to understand the motor control of the upper limb, verifying the speed and accuracy of movement through a computer task. Results: The individuals with sequels of Stroke showed a loss in the strength of the palmar grip and manual function. Besides, they showed a longer time in movement in all index of difficulty compared to Control group. However, they showed a similar behaviour to the healthy individuals throughout the execution of the index of difficulty. Conclusion: Thus, it can be concluded that the individuals with sequels of Stroke showed a deficit of the motor control of the upper limb, compared to the healthy individuals, however, these showed the same behavior, with a bigger deficit in the accuracy of movement
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OBJECTIVE: To analyze the psychomotor development and the fine motor control of institutionalized and non-institutionalized sheltered children and adolescents. METHODS: A cross-sectional study in which 54 subjects participated and were divided into two groups: 27 institutionalized sheltered children and adolescents (SG) and 27 non-institutionalized sheltered children and adolescents (CG). The psychomotor battery and the Learning and Motor Control software were used to evaluate development and motor control. The analysis of variance was performed for both groups with repetitive measurements for the last factor. RESULTS: The SG presented a total development score inferior to the CG, with differences in tonicity (p=0.041) and body awareness (p=0.039). The longest distance was performed on Task 1 (M=983.9 pixels; diagonal line; distance of 930.053 pixels), with no difference between the groups (p=0.64). Furthermore, the SG presented a greater average time in Task 1 (M=16.12 seconds) when compared with Tasks 2 (M=11.6 seconds; horizontal line; distance of 750 pixels) and 3 (M=10.6; vertical line; distance of 550 pixels), but only marginally different between Tasks 2 and 3 (p=0.055). Regarding the number of correct answers, the CG scored more (M=6.1) when compared with SG (M=4.6), with p<0.05. CONCLUSIONS: The institutionalized individuals showed a psychomotor development inferior to the CG. Furthermore, they presented impairment in fine motor control, covering a larger distance on the task that required the diagonal movement, longer execution time, less correct answers, and more errors.
Subject(s)
Adolescent, Institutionalized/statistics & numerical data , Child, Institutionalized/statistics & numerical data , Motor Skills , Adolescent , Analysis of Variance , Case-Control Studies , Child , Cross-Sectional Studies , Female , Humans , Male , SoftwareABSTRACT
ABSTRACT Objective: To analyze the psychomotor development and the fine motor control of institutionalized and non-institutionalized sheltered children and adolescents. Methods: A cross-sectional study in which 54 subjects participated and were divided into two groups: 27 institutionalized sheltered children and adolescents (SG) and 27 non-institutionalized sheltered children and adolescents (CG). The psychomotor battery and the Learning and Motor Control software were used to evaluate development and motor control. The analysis of variance was performed for both groups with repetitive measurements for the last factor. Results: The SG presented a total development score inferior to the CG, with differences in tonicity (p=0.041) and body awareness (p=0.039). The longest distance was performed on Task 1 (M=983.9 pixels; diagonal line; distance of 930.053 pixels), with no difference between the groups (p=0.64). Furthermore, the SG presented a greater average time in Task 1 (M=16.12 seconds) when compared with Tasks 2 (M=11.6 seconds; horizontal line; distance of 750 pixels) and 3 (M=10.6; vertical line; distance of 550 pixels), but only marginally different between Tasks 2 and 3 (p=0.055). Regarding the number of correct answers, the CG scored more (M=6.1) when compared with SG (M=4.6), with p<0.05. Conclusions: The institutionalized individuals showed a psychomotor development inferior to the CG. Furthermore, they presented impairment in fine motor control, covering a larger distance on the task that required the diagonal movement, longer execution time, less correct answers, and more errors.
RESUMO Objetivo: Analisar o desenvolvimento psicomotor e o controle motor fino de crianças e adolescentes institucionalizados e não institucionalizados em abrigo. Métodos: Estudo transversal, no qual participaram 54 indivíduos, divididos em dois grupos: 27 crianças e adolescentes institucionalizados em abrigo (GA) e 27 crianças e adolescentes não institucionalizados (GC) em abrigo. Para avaliação do desenvolvimento e controle motor, foram utilizadas a bateria psicomotora e o software Aprendizagem e Controle Motor. Foi realizada a análise de variância para os dois grupos com medidas repetidas para o último fator. Resultados: O GA apresentou pontuação total do desenvolvimento inferior ao GC, com diferença na tonicidade (p=0,041) e noção corporal (p=0,039). A maior distância percorrida encontrada foi na Tarefa 1 (M=984,9 pixels; com reta diagonal; distância de 930,053 pixels), sem diferença entre os grupos (p=0,64). Além disso, o GA apresentou tempo médio da Tarefa 1 (M=16,1 segundos) superior às Tarefas 2 (M=11,6 segundos; reta horizontal; distância de 750 pixels) e 3 (M=10,6 segundos; reta vertical; distância de 550 pixels), mas apenas marginalmente diferente entre as Tarefas 2 e 3 (p=0,055). Já em relação ao número de acertos, o GC apresentou mais acertos (M=6,1) comparado ao GA (M=4,6), com p<0,05. Conclusões: Os indivíduos institucionalizados apresentaram desenvolvimento psicomotor inferior ao GC, além de comprometimento no controle motor fino com maior distância percorrida na tarefa que exigia o movimento em diagonal, maior tempo na execução, menos acertos e mais erros.