Impact of physiotherapy with telerehabilitation on caregivers of patients with neurological disorders: A systematic review protocol.

Introduction: Caregivers are essential during and after rehabilitation but exhibit intense physical and mental burdens due to responsibilities, resulting in stress, irritability, depression, anxiety, pain, and financial distress. Telerehabilitation offers several remote health services that improve time, engagement, and physical and mental health care access. Thus, we outlined a systematic review protocol to evaluate the impact of telerehabilitation on the burden, stress, pain, and quality of life of caregivers of patients with neurological disorders. Methods: Searches will be conducted in Ovid MEDLINE, Pubmed, Scopus, Web of Science, Embase, Cochrane Central Register of Controlled Trials, Physiotherapy Evidence Database, and PsycINFO databases. Clinical trials evaluating the burden, stress, pain, and quality of life of caregivers of patients with neurological disorders using telerehabilitation will be included without publication date or language restriction. Two reviewers will independently select studies from titles, abstracts, and reference lists. The quality of evidence and risk of bias will be assessed according to Cochrane recommendations. Results: This systematic review to be developed will evaluate the impact of telerehabilitation on the burden, stress, pain, and quality of life of caregivers of patients with neurological disorders. Discussion: Caregivers, especially of patients with neurological disorders, need more attention since the overload, stress, duties with other personal responsibilities, and low remuneration may impact the quality of life. Therefore, they need intervention, especially physical therapy via telehealth, which values the time of caregivers and may change their perception of health and quality of life. PROSPERO registration number: CRD42022278523.

Influence of treadmill gait training with additional load on motor function, postural instability and history of falls for individuals with Parkinson's disease: A randomized clinical trial.

BACKGROUND: Evaluate the effects of additional load (5% and 10% of body weight) with treadmill gait training on the motor aspects in Parkinson's disease (PD). METHODS: Randomized controlled single-blind trial with 30 individuals with PD. The volunteers were divided into three groups (treadmill with 0%, 5% or 10% load), where Unified Parkinson's Disease Rating Scale was applied. Treadmill gait training was conducted over 4 consecutive weeks, with three weekly sessions of 30 min each. RESULTS: There was a significant reduction in all groups in the time factor for motor function (F = 12.92; P = 0.001) and postural instability (F = 11.23; P = 0.002). No significant difference was observed in group × time interaction (F < 1.76; P > 0.19). CONCLUSION: The treadmill comprises an effective therapy for people with PD, for important motor aspects such as motor function and postural instability. Additional load had no influence on results.

Correlation between balance, speed, and walking ability in individuals with chronic hemiparesis / Correlação entre equilíbrio, velocidade e capacidade de deambular em indivíduos com hemiparesia

Abstract Alterations in balance and gait are frequently present in patients with hemiparesis. This study aimed at determining whether there is a correlation between static and functional balance, gait speed and walking capacity. To that end, 17 individuals with chronic hemiparesis of both sexes (58.8% men and 42.25 women), mean age of 56.3 ± 9.73 years, took part in the study. Static balance was assessed by computerized baropodometry, under two different sensory conditions: eyes open (EO) and eyes closed (EC). Functional balance was evaluated by Berg Balance Scale and walking ability by the Functional Ambulation Classification. Gait speed was assessed by kinemetry. The Kolmogorov-Smirnov test was used to verify data distribution normality. Parametric variables were correlated by Pearson's test and their non-parametric parameters by Spearman's test. Functional balance showed a positive correlation with gait speed (p=0.005; r=0.64) and walking ability (p = 0.019; r = 0.56). Anteroposterior (AP) and mediolateral (ML) alterations with EO and EC exhibited negative correlations with gait speed (EO: AP amplitude (p = 0.0049 and r = -0.48); mean ML deviation (p = 0.019 and r =-0.56)/ EC: mean AP deviation (p = 0.018 and r = -0.56) and mean ML deviation (p = 0.032 and r = -0.52); AP amplitude (p = 0.014 and r = -0.57) and ML amplitude (p = 0.032 and r = -0.52); postural instability (p = 0.019 and r = -0.55)) and walking ability (EO: mean AP deviation (p = 0.05 and r = -0.47) and AP amplitude (p = 0.024 and r = -0.54)). The results suggest correlations between static and functional balance and gait speed and walking ability, and that balance training can be an important component of gait recovery protocols.

Resumo Alterações no equilíbrio e marcha são sequelas frequentes em sujeitos com hemiparesia. Este trabalho objetivou verificar se há correlação entre equilíbrio estático e funcional, velocidade e capacidade de deambular. Participaram do estudo 17 sujeitos com hemiparesia crônica, de ambos os sexos (58,8% de homens) com média de idade de 56,3±9,73 anos. A avaliação do equilíbrio estático foi realizada por baropodometria computadorizada em duas condições sensoriais: olhos abertos (AO) e fechados (OF). O equilíbrio funcional foi avaliado pela Escala Equilíbrio de Berg e a capacidade de deambulação, pela Categoria de Deambulação Funcional. A velocidade da marcha foi avaliada por meio da Cinemetria. A normalidade dos dados foi verificada pelo teste de Kolmogorov-Smirnov e as variáveis foram correlacionadas pelos testes de Pearson ou Spearman. O equilíbrio funcional apresentou correlação positiva com a velocidade (p = 0,005; r = 0,64) e com a capacidade de deambulação (p = 0,019; r = 0,56). As oscilações antero-posteriores (AP) e médio-laterais (ML) com OA e OF apresentaram correlações negativas com velocidade da marcha (OA: amplitude AP (p = 0,0049 e r = -0,48); desvio médio ML (p = 0,019 e r = -0,56) / OF: desvio médio AP (p = 0,018 e r = -0,56) e ML (p = 0,032 e r = -0,52); amplitude AP (p = 0,014 e r = -0,57) e ML (p = 0,032 e r = -0,52); instabilidade postural (p = 0,019 e r = -0,55) e com capacidade de deambulação (OA: desvio médio AP (p = 0,05 e r = -0,47) e amplitude AP (p = 0,024 e r = -0,54). Os resultados sugerem a existência de correlações entre o equilíbrio estático e funcional com a velocidade de marcha e capacidade de deambular, bem como que o treino do equilíbrio pode ser um importante componente para protocolos de recuperação da marcha.