Neurostimulation Combined With Cognitive Intervention in Alzheimer's Disease (NeuroAD): Study Protocol of Double-Blind, Randomized, Factorial Clinical Trial.

Despite advances in the treatment of Alzheimer's disease (AD), there is currently no prospect of a cure, and evidence shows that multifactorial interventions can benefit patients. A promising therapeutic alternative is the use of transcranial direct current stimulation (tDCS) simultaneously with cognitive intervention. The combination of these non-pharmacological techniques is apparently a safe and accessible approach. This study protocol aims to compare the efficacy of tDCS and cognitive intervention in a double-blind, randomized and factorial clinical trial. One hundred participants diagnosed with mild-stage AD will be randomized to receive both tDCS and cognitive intervention, tDCS, cognitive intervention, or placebo. The treatment will last 8 weeks, with a 12-month follow-up. The primary outcome will be the improvement of global cognitive functions, evaluated by the AD Assessment Scale, cognitive subscale (ADAS-Cog). The secondary outcomes will include measures of functional, affective, and behavioral components, as well as a neurophysiological marker (Brain-derived neurotrophic factor, BDNF). This study will enable us to assess, both in the short and long term, whether tDCS is more effective than the placebo and to examine the effects of combined therapy (tDCS and cognitive intervention) and isolated treatments (tDCS vs. cognitive intervention) on patients with AD. Clinical Trial Registration: www.ClinicalTrials.gov, identifier NCT02772185-May 5, 2016.

Percepção Fisioterapêutica de Indivíduos Parkinsonianos Correlacionando Escalas de Avaliação / Physiotherapeutic Perception Of Parkinsonian Individuals correlating Assessment Scales

A doença de Parkinson é caracterizada portremor, bradicinesia, rigidez e instabilidade postural. Podeacarretar alterações neurológicas, cognitivas e respiratórias,provocando limitações funcionais que variam conforme onível de gravidade sintomatológico e ocasionando diminuiçãodas atividades de vida diária e laborais, além de umaprogressiva postura de afastamento do convívio social.Objetivo: Correlacionar escalas de avaliação do estadocinético-funcional, do comprometimento cognitivo e daqualidade de vida em três indivíduos com doença deParkinson. Material e Métodos: Participaram três pacientes,duas do sexo feminino e um do sexo masculino, com faixaetária variando de 51 a 61 anos e nível de escolaridadedesde o ensino fundamental menor completo até pósgraduaçãona área da educação. Para caracterizar os sujeitosdo estudo em relação ao estadiamento da doença deParkinson, utilizou-se antes de iniciar o tratamentofisioterapêutico os seguintes questionários: Mini-MentalState Examination (MEEM), Medida de IndependênciaFuncional (MIF), Parkinson’s Disease Questionnaire (PDQ-39) e Escala de Mobilidade e Equilíbrio de Tinetti / Teste doAndar. Resultados: Quanto à análise do equilíbrio e da marcha,os três pacientes apresentaram déficit em ambos, sendoque com movimentos distintos para deambular, como: marchalenta, passos curtos e passos assimétricos. Todos ospacientes também demonstraram moderado risco de quedas.Conclusão: Observou-se a existência de correlação quantoà aplicação das escalas de avaliação do estado cinéticofuncional,visto que os três pacientes possuem equilíbrio emarcha deficitários atestados na Escala de Mobilidade e Equilíbrio de Tinetti e no Teste do Andar...

Introduction: Parkinson’s disease is characterized by tremor,bradykinesia, rigid muscles, and postural instability. It maylead to neurological, cognitive, and respiratory alterations,causing functional limitations that vary according to the levelof symptomatic severity. As a result, daily life and labouractivities may be decreased, in addition to gradual self-removalfrom social life. Objective: To correlate assessment scalesfrom the kinetic functional state, cognitive impairment, andquality of life in three individuals living with Parkinson’sdisease. Material and Methods: Three patients were involvedin the study, two female and one male, age group varyingbetween 51 and 61 years and educational level varying sincecompleted elementary school up to graduate degree in theeducational area. In order to characterize the study subjectsas to Parkinson’s disease staging, before starting thephysiotherapeutic treatment, the following questionnaireswere used: Mini-Mental State Examination (MEEM), FunctionalIndependence Measure (FIM), Parkinson’s DiseaseQuestionnaire (PDQ-39), and Tinetti Mobility and BalanceScale / Gait Scale. Results: The three patients presenteddeficit in both balance and gait analyses, with distinct walkingmovements, such as idling, short steps and asymmetricalsteps. All patients also showed moderate risk of falls.Conclusion: There was a correlation as to the application ofthe assessment scales of the kinetic-functional state, giventhat the three patients showed balance and gait deficitsdetected in the Tinetti’s Mobility and Balance Scale and in theGait test...

Perfil sociodemográfico e índice de qualidade de vida de cuidadores de pessoas com deficiência física / Socio-demographic profile and quality of life index for caregivers of people with physical disabilities

O objetivo do estudo foi identificar o perfil sociodemográfico e o nível de qualidade de vida de cuidadores de pessoas com deficiência física atendidas na Fundação Centro Integrado de Apoio ao Portador de Deficiência Física (FUNAD) no município de João Pessoa (PB). Participaram do estudo 51 cuidadores de pessoas com deficiência física, na faixa etária de 19 a 63 anos (36,29±11,10). Para a avaliação foram utilizados dois instrumentos: um formulário estruturado, com questões sobre o perfil pessoal e social dos cuidadores e o World Health Organization Quality of Life (WHOQOL-bref), para a análise do nível de qualidade de vida. Os resultados apontaram que a maioria dos cuidadores eram mulheres (92,2), mães (68,6), solteiras (43,1) e haviam frequentado a escola até o Ensino Fundamental incompleto (47). Houve significância estatística (p<0,05), com correlação positiva entre idade e tempo de atuação como cuidador atual (p=0,000); e correlação negativa entre escolaridade e tempo de cuidado diário (p=0,009). Constatou-se que o estresse físico e o emocional levam os cuidadores a ficarem sobrecarregados, afetando diretamente sua qualidade de vida. Ressalta-se a importância da investigação do estilo de vida desses cuidadores no intuito de que ações sociais e de saúde sejam desenvolvidas pelas instituições que assistem pessoas com deficiência física.

The study objective was to identify the socio-demographic profile and the level of quality of life of caregivers of persons with disabilities met with the Foundation to Support Integrated Patient with Physical Disabilities (FUNAD) in the city of Joao Pessoa, in the state Paraíba, Brazil. The study had 51 participants, caregivers of people with disabilities in the age group 19-63 years (36.29±11.10). For the evaluation, we used two instruments: a structured form, with questions about personal and social profiles, and World Health Organization Quality of Life (WHOQOL-bref), to analyze the level of quality of life. The results showed that most caregivers were women (92.2), mothers (68.6), single (43.1) and had attended up to elementary school (47). Statistical significance (p<0.05), a positive correlation between age and time working as a caregiver present (p=0.000) and negative correlation between schooling and daily care time (p=0.009). It was found that the physical and emotional stress leads caregivers to encumber themselves, directly affecting the quality of life. We highlight the importance of research in lifestyle of caregivers, in order that social action and health are developed by institutions assisting people with disabilities.