ABSTRACT
INTRODUÇÃO: A ocorrência de quedas está entre as complicações mais frequentes apresentadas por idosos e portadores de doenças neurológicas. Sabe-se que em idosos há maior frequência de quedas em mulheres. Em indivíduos após AVC, essa relação não é estabelecida. OBJETIVO: Diferenciar as características clínicas e funcionais de mulheres caidoras e não caidoras após AVC e verificar a associação entre mobilidade funcional e capacidade funcional nessas mulheres. DESENHO DE ESTUDO E LOCAL: Trata-se de um estudo prospectivo longitudinal realizado em Salvador (BA). MÉTODOS: Foram incluídas mulheres com marcha independente atendidas em ambulatório de referência. Foram coletados dados sociodemográficos e clínicos e aplicados a Escala do National Institutes of Health Stroke, o Índice de Barthel modificado, o Timed Up and Go (TUG) e a qualidade de vida europeia. O nível de significância adotado foi de 5%. RESULTADOS: Foram selecionadas 68 mulheres com média de idade de 56 (± 13,7) anos, 51% das mulheres caíram no seguimento, esta última tinha menos de 55 anos (± 13,4), com maior gravidade do AVC. O comprometimento do território vascular posterior foi mais evidente entre as mulheres que caíram (P = 0,009), mas todas, as que caíram e as que não caíram, apresentaram mobilidade funcional prejudicada (TUG = 15 segundos). No entanto, a amostra total foi classificada como totalmente independente ou com leve dependência das atividades de vida diária (AVDs) (MBI = 49). A correlação entre o tempo de TUG e MBI foi negativa e significativa (R = -0,702, P ≤ 0,001). CONCLUSÕES: O envolvimento da circulação posterior é um importante preditor de quedas, sendo um importante indicador no acompanhamento de mulheres após AVC. Também enfatiza que a menor mobilidade funcional impactou a capacidade funcional da mulher.
BACKGROUND: Occurrence of falls is among the most frequent complications presented by the elderly and individuals with neurological diseases. It is known that in the elderly, there is a greater frequency of falls in women. However, in individuals after stroke, this relationship is not established. The purpose of this study was to differentiate the clinical and functional characteristics of fallers and non-fallers women after stroke and to verify the association between functional mobility and functional capacity in these women. DESIGN AND SETTING: This is a longitudinal prospective study conducted in Salvador, Bahia, Brazil. METHODS: Women with independent gait assisted in a reference outpatient clinic were included. Sociodemographic and clinical data were collected, and the National Institutes of Health Stroke Scale, Modified Barthel Index, Timed Up and Go (TUG), and European quality of life were applied. The level of significance was set at 5%. RESULTS: A total of 68 women with a mean age of 56 (± 13.7) years were selected; 51% of the women fell in the follow-up, the latter was younger than 55 years (± 13.4), with greater severity of the stroke. Impairment in the posterior vascular territory was more evident among falling women (P = 0.009), but all falling and non-falling women presented impaired functional mobility (TUG = 15seconds). However, the total sample was classified as totally independent or with slight dependence on the activities of daily living (ADLs) (MBI = 49). The correlation between TUG time and MBI was negative and significant (R = -0.702, P ≤ 0.001). CONCLUSIONS: The involvement of posterior circulation is an important predictor of falls, an important indicator in the monitoring of women after stroke. It also emphasizes that the lower functional mobility impacted women's functional capacity.
Subject(s)
Longitudinal Studies , Women , StrokeABSTRACT
| INTRODUÇÃO: O vírus linfotrópico de células T humana tipo 1 (HTLV-1) é classificado como retrovírus e pode estar diretamente associado às doenças neurológicas. Por ser uma doença negligenciada pelas autoridades sanitárias e governamentais num panorama mundial, ainda existe uma carência de evidências científicas que investigam o impacto do HTLV-1 no âmbito da participação social dessa população. OBJETIVO: Analisar o impacto da pandemia da COVID-19 na participação social de indivíduos com HTLV-1. MATERIAL E MÉTODOS: Trata-se de um estudo observacional do tipo transversal realizado com indivíduos com HTLV-1 vinculados à Associação HTLVida. A coleta de dados foi realizada através de entrevistas via videoconferência; a primeira entrevista teve como objetivo explorar as características clínicas e sociodemográficas dos participantes, já a segunda investigou a participação social dos indivíduos comparando dois períodos (antes e durante a pandemia de COVID-19), através da aplicação do Questionário de Integração na Comunidade (QIC). RESULTADOS: Foram entrevistados 11 indivíduos, com predominância do sexo feminino (72,7%), com mediana de idade de 57 (52- 66) anos. No que tange os resultados referentes à participação social avaliada pelo QIC, observou-se a manutenção do escore do domínio de integração no ambiente doméstico, uma diferença de 3.00 pontos no domínio de integração no ambiente social, uma diferença de 2.00 pontos no domínio de integração no ambiente do trabalho e escola, além de uma diferença de 6.00 pontos no escore total do QIC. CONCLUSÃO: Identificou-se uma diminuição da participação social de indivíduos com HTLV-1 durante a pandemia da COVID-19, quando comparado ao período prévio de início da pandemia.
INTRODUCTION: Human T-cell Lymphotropic Virus type 1 (HTLV-1) is classified as a retrovirus and may be directly associated with neurological diseases. As it is a disease neglected by health and governmental authorities in a world panorama, there is still a lack of scientific evidence that investigates the impact of HTLV-1 in the scope of the social participation of this population. OBJECTIVE: To analyze the impact of the COVID-19 pandemic on the social participation of individuals with HTLV-1. MATERIAL AND METHODS: This is a transversal observational study carried out with individuals with HTLV-1, linked to the HTLVida Association. The data collection was carried out through interviews in a videoconference. The first interview aimed to explore the clinical and sociodemographic characteristics of the participants. In contrast, the second one investigated the social participation of individuals comparing two periods (before and during the COVID-19 pandemic) through the application of the Community Integration Questionnaire (CIQ). RESULTS: Eleven individuals were interviewed, predominantly female (72.7%), with a median age of 57 (52-66). About the results regarding social participation evaluated by the CIQ, was observed maintenance of the score in the domain of Integration in the home environment, a difference of 3.00 points in the domain of Integration in the social environment, a difference of 2.00 points in the domain of Integration in the work and school environment, and a difference of 6.00 points in the total CIQ score. CONCLUSION: A decrease in the social participation of individuals with HTLV-1 during the COVID-19 pandemic was compared to the period before the start of the pandemic.
Subject(s)
Humans , Male , Female , Middle Aged , Aged , HTLV-I Infections , Quarantine , Social Participation , COVID-19/prevention & control , Cross-Sectional Studies , Surveys and QuestionnairesABSTRACT
INTRODUCTION: Individuals with human T-cell lymphotropic virus 1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) experience sensorimotor alterations, which can affect functional performance. Virtual reality (VR) videogaming is a therapeutic option, though there is scarce evidence for its use in this population. We aimed to investigate the therapeutic effects of a VR video game on functional mobility, balance, and gait speed in individuals with HAM/TSP. METHODS: We conducted a blinded, crossover clinical trial comprising 29 individuals with HAM/TSP and randomized them into two groups: (1) early therapy: rehabilitative protocol started immediately after the initial evaluation and (2) late therapy: rehabilitative protocol started 10 weeks later. We assessed all participants for balance using the Berg Balance Scale (BBS) scores, functional mobility using the Timed Up and Go (TUG) test, and gait speed using video camera and CvMob software. Differences were considered significant if p<0.05. RESULTS: The early therapy group individuals presented with higher BBS scores (p=0.415), less TUG times (p=0.290), and greater gait speed (p=0.296) than the late therapy group individuals. CONCLUSIONS: VR videogaming is a useful option for rehabilitative therapy in individuals with HAM/TSP; it positively affects balance, functional mobility, and gait speed.
Subject(s)
Human T-lymphotropic virus 1 , Paraparesis, Tropical Spastic , Video Games , Virtual Reality , Humans , Paraparesis, Tropical Spastic/therapy , Walking SpeedABSTRACT
Abstract INTRODUCTION: Individuals with human T-cell lymphotropic virus 1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) experience sensorimotor alterations, which can affect functional performance. Virtual reality (VR) videogaming is a therapeutic option, though there is scarce evidence for its use in this population. We aimed to investigate the therapeutic effects of a VR video game on functional mobility, balance, and gait speed in individuals with HAM/TSP. METHODS: We conducted a blinded, crossover clinical trial comprising 29 individuals with HAM/TSP and randomized them into two groups: (1) early therapy: rehabilitative protocol started immediately after the initial evaluation and (2) late therapy: rehabilitative protocol started 10 weeks later. We assessed all participants for balance using the Berg Balance Scale (BBS) scores, functional mobility using the Timed Up and Go (TUG) test, and gait speed using video camera and CvMob software. Differences were considered significant if p<0.05. RESULTS: The early therapy group individuals presented with higher BBS scores (p=0.415), less TUG times (p=0.290), and greater gait speed (p=0.296) than the late therapy group individuals. CONCLUSIONS: VR videogaming is a useful option for rehabilitative therapy in individuals with HAM/TSP; it positively affects balance, functional mobility, and gait speed.
Subject(s)
Humans , Human T-lymphotropic virus 1 , Paraparesis, Tropical Spastic/therapy , Video Games , Virtual Reality , Walking SpeedABSTRACT
INTRODUÇÃO: A hidroterapia é cada vez mais utilizada no tratamento de pacientes com doença neurodegenerativas visando melhora da funcionalidade e redução de quedas. Permite treino de marcha em condições seguras, promove relaxamento e reduz o medo de cair. Há a necessidade de analisar a qualidade metodológica dos estudos existentes neste contexto. OBJETIVO: Sistematizar o conhecimento acerca da efetividade do treino de marcha na água para pessoas com Doença de Parkinson. MÉTODOS: Trata-se de uma revisão sistemática. Foi feita busca na base de dados do Pubmed e Lilacs no período de março de 2017 a maio de 2018 sem filtros. Foram incluídos ensaios clínicos randomizados que verificaram efeitos de um protocolo de treino de marcha na água para pacientes com Doença de Parkinson. Foram excluídos estudos que realizaram treino na água, porém não especificamente de marcha. Foi utilizada ferramenta da Colaboração Cochrane para avaliar a qualidade metodológica dos estudos. RESULTADOS: Foram encontrados quinze estudos na busca, três destes foram incluídos. Houve uma diferença entre os artigos quanto aos desfechos, em relação ao aumento da velocidade da marcha. A análise da qualidade metodológica mostrou falhas de randomização e cegamento na metodologia dos estudos. CONCLUSÃO: Foi evidenciado que o treino de marcha na água tem efeitos positivos na velocidade da marcha e na mobilidade destes indivíduos. Para um resultado clínico positivo na marcha, devem ser associados exercícios para mobilidade e equilíbrio. São necessários futuros ensaios clínicos randomizados que sigam as diretrizes e apresentem uma qualidade metodológica satisfatória. [AU]
INTRODUCTION: Hydrotherapy is increasingly used in the treatment of patients with neurodegenerative disease, being aimed at improving functionality and reduce falls. Allows safe walking, promotes relaxation and reduces fear of falling. There is a requirement to analyze the methodological quality of existing studies in this context. OBJECTIVE: To systematize the knowledge about the effectiveness of water walking training for people with Parkinson's disease. METHODS: This is a systematic review. We searched the Pubmed and Lilacs database from March 2017 to May 2018 without filters. We included randomized clinical trials that verified the effects of a water gait training protocol for patients with Parkinson's disease. We excluded studies that performed water training, but not specifically gait. A Cochrane Collaboration tool was utilized to evaluate the methodological quality of the studies. RESULTS: Fifteen studies were found in the search, three of these were included. There was different from those between the articles regarding outcomes, in relation to the increase in walking speed. The methodological quality analysis showed randomization and blindness failure in the methodology of the studies. CONCLUSION: It was evidenced that gait training in water has a positive effect on gait velocity and the mobility of these individuals. For a positive clinical outcome in walking, exercises for mobility and balance should be associated. Further randomized clinical trials are necessary for follow the guidelines and have satisfactory methodological quality. [AU]
Subject(s)
Parkinson Disease , Hydrotherapy , GaitABSTRACT
Introdução: A função sensorial é reconhecida como precursora da recuperação do movimento, sendo assim, os sintomas apresentados por pessoas com HTLV-1 podem trazer prejuízo na realização de atividades funcionais Objetivo: Sistematizar o conhecimento sobre alterações sensoriais em pacientes com HTLV-1. Metodologia: Trata-se de uma revisão sistemática, com a busca primária dos artigos realizada nas bases de dados Medline, via biblioteca virtual Pubmed, sendo incluídos estudos observacionais que abordaram a alteração sensorial em indivíduos com HTLV-1. A estratégia de busca foi conduzida de forma independente por dois pesquisadores e as divergências resolvidas por consenso. Resultados: Foram encontrados 44 estudos na busca primária, e destes foram incluídos quatro estudos que abordaram a alteração sensorial em indivíduos com HTLV-1, com um total de 240 participantes. Todos os artigos foram classificados como baixo risco de viés no que diz respeito à descrição da questão do estudo, resultados e discussão. Conclusão: identificou-se uma alta prevalência de dor e alteração na sensibilidade vibratória em relação às outras disfunções sensoriais, no entanto, a escassez de trabalhos publicados acerca deste tema sugere que novas abordagens sejam feitas mostrando uma grande lacuna de conhecimento a ser explorada. [AU]
Background: Sensory function is recognized as a precursor of the movement recovery. Therefore, the symptoms presented by people with HTLV-1 can result in impairment in the performance of functional activities. Aim: To systematize knowledge about sensory alterations in patients with HTLV-1. Methods: This is a systematic review, with the primary search of the articles carried out in the Medline databases, via the Pubmed virtual library, including observational studies that addressed the sensory alteration in individuals with HTLV-1. The search strategy was conducted independently by two researchers and the divergences resolved by consensus. Results: A total of 44 studies were found in the primary search, including four studies addressing sensory impairment in individuals with HTLV-1, with a total of 240 participants. All articles were classified as low risk of bias regarding the description of the study question, results and discussion. Conclusion: We identified a high prevalence of pain and altered vibratory sensitivity in relation to other sensory disorders, however, shortage of published works on this topic suggests new approaches are made showing a large knowledge gap to be explored. [AU]
Subject(s)
Viruses , Paraparesis , SensationABSTRACT
INTRODUCTION: Human T-cell lymphotropic virus type-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) may lead to reduced functional mobility and balance. It is important to establish specific parameters that identify these changes and predict the risk of falls in these patients. The aim was to compare balance, functional mobility, and occurrence of falls among patients with and without HAM/TSP and to suggest values to predict the risk of falls in these patients. METHODS: A cross-sectional study in patients with and without HAM/TSP involved balance assessments based on the berg balance scale (BBS) and functional mobility evaluation based on the timed up and go (TUG) test. From reports of falls, the sensitivity, specificity, and best cutoff points for the risk of falls assessed by these instruments were established using the receiver-operating characteristic (ROC) curve; 5% alpha was considered. RESULTS: We selected 42 participants: 29 with HAM/TSP and 13 without HAM/TSP. There was a statistically significant difference in the occurrence of falls, balance, and functional mobility between the groups (p<0.05). Good accuracy was determined for the BBS (77%) and TUG test (70%) and the cutoff points for the risk of falls were defined as 50 points for the BBS and 12.28 seconds for the TUG test. CONCLUSIONS: Patients with HAM/TSP present reduced functional mobility and balance in relation to those without HAM/TSP. The risk of falls increased for these patients can be evaluated by the values ââof 50 points using the BBS and 12.28 seconds using the TUG test.
Subject(s)
Accidental Falls/statistics & numerical data , Human T-lymphotropic virus 1 , Mobility Limitation , Paraparesis, Tropical Spastic/complications , Postural Balance/physiology , Sensation Disorders/physiopathology , Activities of Daily Living , Adult , Disability Evaluation , Epidemiologic Methods , Female , Humans , Male , Paraparesis, Tropical Spastic/physiopathology , Paraparesis, Tropical Spastic/virology , Sensation Disorders/virology , Socioeconomic FactorsABSTRACT
Abstract INTRODUCTION: Human T-cell lymphotropic virus type-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) may lead to reduced functional mobility and balance. It is important to establish specific parameters that identify these changes and predict the risk of falls in these patients. The aim was to compare balance, functional mobility, and occurrence of falls among patients with and without HAM/TSP and to suggest values to predict the risk of falls in these patients. METHODS: A cross-sectional study in patients with and without HAM/TSP involved balance assessments based on the berg balance scale (BBS) and functional mobility evaluation based on the timed up and go (TUG) test. From reports of falls, the sensitivity, specificity, and best cutoff points for the risk of falls assessed by these instruments were established using the receiver-operating characteristic (ROC) curve; 5% alpha was considered. RESULTS: We selected 42 participants: 29 with HAM/TSP and 13 without HAM/TSP. There was a statistically significant difference in the occurrence of falls, balance, and functional mobility between the groups (p<0.05). Good accuracy was determined for the BBS (77%) and TUG test (70%) and the cutoff points for the risk of falls were defined as 50 points for the BBS and 12.28 seconds for the TUG test. CONCLUSIONS: Patients with HAM/TSP present reduced functional mobility and balance in relation to those without HAM/TSP. The risk of falls increased for these patients can be evaluated by the values of 50 points using the BBS and 12.28 seconds using the TUG test.
Subject(s)
Humans , Male , Female , Adult , Accidental Falls/statistics & numerical data , Human T-lymphotropic virus 1 , Paraparesis, Tropical Spastic/complications , Sensation Disorders/physiopathology , Postural Balance/physiology , Mobility Limitation , Socioeconomic Factors , Activities of Daily Living , Paraparesis, Tropical Spastic/physiopathology , Paraparesis, Tropical Spastic/virology , Epidemiologic Methods , Sensation Disorders/virology , Disability EvaluationABSTRACT
Crianças deficientes visuais necessitam acompanhamento multiprofissional desde a primeira infância para monitorar o seu desenvolvimento neuropsicomotor, principalmente no que diz respeito ao atraso na aquisição do equilíbrio. O objetivo desse estudo foi relatar casos de alteração de equilíbrio em crianças com deficiência visual. Foi realizada avaliação do equilíbrio estático em crianças de três a cinco anos, cuja única patologia era a deficiência visual. Para tanto, foram utilizados os subtestes de equilíbrio presentes na Escala de Desenvolvimento Motor. As crianças avaliadas com idade entre 36 e 48 meses tiveram os menores atrasos na manutenção da postura estática, enquanto aquelas de 48 a 60 meses apresentaram atrasos importantes. Não houve influência da estimulação precoce na aquisição do equilíbrio estático, sugerindo a dificuldade que crianças deficientes visuais têm para se manterem estáticas. (AU)
Visually impaired children require from their early childhood multiprofessional monitoring of their neurological and psychomotor development, especially concerning their delay in acquiring balance skills. This is a report on balance alterations in visually impaired children. Static balance assessment was carried out in three-to-five-year-old children presenting visual impairment as the only alteration, by using balance subtests from the Motor Development Scale. Children aging from 36 to 48 months showed the shortest delays in maintaining a static posture, whereas those aging between 48 and 60 months showed longer delays. Early stimulation did not influence in balance skills acquisition, thus suggesting how difficult it is for visually impaired children to maintain a static posture. (AU)
Subject(s)
Humans , Male , Female , Child, Preschool , Visually Impaired Persons , Child, Preschool , Child Development , Psychomotor PerformanceABSTRACT
Crianças deficientes visuais necessitam acompanhamento multiprofissional desde a primeira infância para monitorar o seu desenvolvimento neuropsicomotor, principalmente no que diz respeito ao atraso na aquisição do equilíbrio. O objetivo desse estudo foi relatar casos de alteração de equilíbrio em crianças com deficiência visual. Foi realizada avaliação do equilíbrio estático em crianças de três a cinco anos, cuja única patologia era a deficiência visual. Para tanto, foram utilizados os subtestes de equilíbrio presentes na Escala de Desenvolvimento Motor. As crianças avaliadas com idade entre 36 e 48 meses tiveram os menores atrasos na manutenção da postura estática, enquanto aquelas de 48 a 60 meses apresentaram atrasos importantes. Não houve influência da estimulação precoce na aquisição do equilíbrio estático, sugerindo a dificuldade que crianças deficientes visuais têm para se manterem estáticas.
Visually impaired children require from their early childhood multiprofessional monitoring of their neurological and psychomotor development, especially concerning their delay in acquiring balance skills. This is a report on balance alterations in visually impaired children. Static balance assessment was carried out in three-to-five-year-old children presenting visual impairment as the only alteration, by using balance subtests from the Motor Development Scale. Children aging from 36 to 48 months showed the shortest delays in maintaining a static posture, whereas those aging between 48 and 60 months showed longer delays. Early stimulation did not influence in balance skills acquisition, thus suggesting how difficult it is for visually impaired children to maintain a static posture.