Função sensorial em membros superiores e atividades funcionais de indivíduos pós AVC / Sensory function in upper limb and functional activities of individuals after stroke

O Acidente Vascular Cerebral é uma patologia incapacitante e tem alto índice de morbimortalidade no Brasil. Essa condição pode gerar um impacto na homeostase das funções motoras e sensoriais. São necessários mais estudos de reabilitação com essa população visto que há lacunas no que se refere à descrição das intervenções e orientações específicas para a função sensorial. Diante disto, objetivou-se relacionar a função sensorial com a função motora e a capacidade funcional de indivíduos após AVC. Foram utilizadas a Avaliação Sensorial de Nottingham, Medida de Independência Funcional e Escala Fugl Meyer. A amostra foi composta por 35 voluntários sendo observados que quanto maior a pontuação na função sensorial melhor seria o desempenho nas funções motoras. Ao associar a função sensorial, o desempenho motor e as atividades funcionais os sujeitos necessitavam de supervisão; foram mais independentes os que apresentaram os itens "toque" e "pressão" considerados como normais. Conclui-se que houve alterações das funções somatossensoriais e motoras que geraram impacto nas atividades funcionais.

Stroke is a disabling disease and has a high rate of morbidity and mortality in Brazil. This condition can have an impact on the homeostasis of motor and sensory functions. Further rehabilitation studies are needed with this population, as there are gap regarding the description of interventions and specific guidelines for sensory function. Given this, the objective was to relate the sensory function with the motor function and the functional capacity of individuals after stroke. Nottingham Sensory Assessment, Functional Independence Measure and Fugl Meyer Scale were used. The sample consisted of 35 volunteers and it was observed that the higher the score on sensory function, the better the performance on motor functions. When associating sensory function, motor performance and functional activities, the subjects needed supervision; those who presented the items "touch" and "pressure" were considered more independent. It was concluded that there were changes in somatosensory and motor functions that impacted functional activities.KEYWORDS: Upper extremity; Sensation; Stroke; Reabilitation; Motor activity.ARTIGO ORIGINALReis JC

Self-efficacy assessment tools for individuals with depression: protocol for a systematic review of the literature.

INTRODUCTION: Depression is a common debilitating disease that affects individuals in all age groups. The impact of the diagnosis extends beyond the individual, with negative effects on mental health, physical health and social well-being. Self-efficacy has been referenced as an important aspect to the prognosis of mood disorders by conferring co-responsibility to the affected individual to face his/her health problems. Several assessment tools are found in the literature for measuring self-efficacy, but it is not yet clear which of these measures are more applicable to individuals with mood disorders, particularly depression. Thus, the aim of present study is to propose a systematic review to examine the psychometric properties and applicability of assessment tools designed to measure self-efficacy in individuals with symptoms and/or a diagnosis of depression. METHODS AND ANALYSIS: This protocol is reported in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols statement and the review will be reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. The evaluation of the psychometric properties of the health outcome measures will be conducted according to COSMIN guidelines. Two independent reviewers will perform the electronic searches in the PubMed, Web of Science, PsycInfo, SCOPUS and CINAHL databases, followed by the use of the 'snowball' strategy. The inclusion criteria will be (1) instrument validation studies, (2) developed with individuals of any age (3) with symptoms or a diagnosis of depression. Two independent reviewers will analyse the titles and abstracts of the articles retrieved during the search for pre-selection, followed by full-text analyses to determine inclusion in the review based on the eligibility criteria. Cases of a divergence of opinion will be resolved by a third reviewer. Descriptive analysis of the articles will be performed (data on participants, characteristics, psychometric properties and clinical usefulness of the assessment tools). ETHICS AND DISSEMINATION: The proposed systematic review will provide information on assessment tools employed to measure self-efficacy with regard to coping with depression, offering data on the psychometric properties, strong and weak points, and clinical applicability. As a secondary analysis of the literature, the approval of an ethics committee is not required. PROSPERO REGISTRATION NUMBER: CRD42017078707.

Interferência das variáveis sexo e idade no olfato e no paladar em crianças com e sem rinite alérgica / Interference of variables sex and age in olfaction and taste of children with and without allergic rhinitis

RESUMO Objetivo Investigar associação de olfato e paladar com a idade e o sexo, em crianças com e sem rinite alérgica. Métodos Estudo observacional, comparativo, analítico e transversal. Amostra composta por 127 crianças, sendo 85 sem rinite alérgica e 42 com rinite alérgica, entre 7 e 12 anos de idade, atendidas no Hospital das Clínicas da Universidade Federal de Pernambuco. Foi realizada revisão de prontuário, entrevista com os responsáveis, limpeza nasal, avaliação do olfato por meio de teste embasado na literatura - desenvolvido para esta pesquisa -, higienização bucal e avaliação do paladar, mediante teste das tiras gustativas. Os dados foram tabulados e analisados no programa estatístico SPSS 17.0 e considerou-se o nível de significância de 5%. Utilizou-se o Teste Qui-quadrado ou exato de Fisher, além da frequência absoluta e relativa dos dados. Resultados O estudo evidenciou semelhanças entre os níveis de discriminação olfatória e gustatória em sexos e faixas etárias diferentes, nas crianças com e sem rinite alérgica, observada ausência de associações estatisticamente significativas nestas condições. Conclusão Os resultados do estudo se contrapõem à literatura pesquisada, porém contribuem no estabelecimento de escores da quantificação olfatória e gustativa para sexos e idades diferentes, em crianças com e sem rinite alérgica.

ABSTRACT Purpose To associate smell and taste with age and sex of children with and without allergic rhinitis. Methods This is an observational, comparative, analytical and cross-sectional study with a sample of 127 children, 85 without allergic rhinitis and 42 with allergic rhinitis aged 7-12 years attended at the Clinics Hospital of Pernambuco. The research started on January 2012 and was approved by the Ethics Research Committee. The Free and Informed Consent Form was applied, then, medical report review, interview with parents / caregivers, nasal cleaning, evaluation of smell using a test based on literature developed for this study, oral hygiene and taste evaluation using the taste strip test were performed. Data were analyzed using the SPSS 17.0 software, considering 0.05 significance level using the Chi-square or Fisher's exact test, in addition to absolute and relative frequency data. Results The study highlights similarities between levels of olfactory and gustatory discrimination between different sexes and age groups of children (with and without allergic rhinitis), as there is lack of statistically significant associations under these conditions. Conclusion The study results contradict literature findings, but contribute in establishing olfactory and gustatory quantification scores for different ages and sexes of children with and without allergic rhinitis.

Motor imagery and swallowing: a systematic literature review / Imagética motora e deglutição: uma revisão sistemática da literatura

ABSTRACT Objetive: to identify, in the literature, studies that address the use of motor imagery of swallowing. Methods: a systematic review in SCOPUS databases, Science Direct and Medline, with descriptors and free terms "Motor Imagery"; "Swallow"; "Feeding"; "Stomatognathic System"; "mastication ", "Chew "; "Deglutition "; "Deglutition Disorders "; and "Mental Practice". Original articles using the motor imagery of swallowing were included, while reviews were excluded. For data analysis, at the first and second steps, the reading of titles and abstracts of the studies was carried out. In the third step, all studies that were not excluded were read in full. Results: four manuscripts were selected. The use of motor imagery in the rehabilitation of swallowing shows to be a recent proposal (2014-2015). The sample was reduced and comprised mainly healthy individuals. The EMG of the supra-hyoid muscles was used in two manuscripts. The most used neuroimaging technique was the Near-Infrared Spectroscopy, demonstrating the occurrence of hemodynamic changes during motor imagery and motor execution of swallowing. Conclusion: the motor imagery produces brain response in the motor area of the brain, suggesting that mentalization of actions related to swallowing is effective. However, further studies are needed for the application of this approach in the swallowing rehabilitation.

RESUMO Objetivo: identificar na literatura os estudos que abordem o uso da imagética motora da deglutição. Métodos: uma revisão sistemática nas bases de dados SCOPUS, Science Direct e MedLine, com os descritores e termos livres: "Motor Imagery"; "Swallow"; "Feeding"; "Stomatognathic System"; "Mastication", "Chew"; "Deglutition"; "Deglutition Disorders"; e "Mental Practice". Incluídos artigos originais, com o uso da imagética motora da deglutição. Excluídas as revisões. Para análise dos dados, na primeira e segunda etapas foram realizadas a leitura dos títulos e dos resumos dos estudos. Na terceira etapa, todos os estudos que não foram excluídos foram lidos na íntegra. Resultados: foram selecionados 4 manuscritos. O uso da imagética motora na reabilitação da deglutição suscita ser uma proposta recente (2014 - 2015). A amostra foi reduzida e composta majoritariamente por indivíduos saudáveis. A Eletromiografia dos músculos supra-hioides foi utilizada em dois manuscritos. A técnica de neuroimagem mais utilizada foi o Near-Infrared Spectroscopy, demonstrando a ocorrência de mudanças hemodinâmicas durante a imagética motora e execução motora da deglutição. Conclusão: identificou-se que a imagética motora produz resposta cerebral na área motora do cérebro, sugerindo que a mentalização das ações relacionadas à deglutição é eficaz. No entanto, são necessários novos estudos para aplicação desta abordagem na reabilitação da deglutição.

Quantitative evaluation of taste in childhood populations: a systematic review / Avaliação quantitativa do paladar na população infantil: revisão sistemática

Introduction: Taste is of great importance for the feeding process. Seen in this light, it is essential to investigate this sense in children as developing human beings. However, despite little variation in the use of tests that measure the gustatory capacity, there are still questions about the applicability and effective use of tools for quantitative assessment in children. Objective: To search the literature on quantitative instruments used for the evaluation of taste used in studies with children. Methods: A search was conducted in the PUBMED and Web of Science platforms, and subsequently, the identified articles were selected and reviewed. The descriptors and terms used were "taste," "child," "assessment," "diagnosis," and "dysgeusia". Original articles related to the theme in English, restricted to children and with no year limitation, were selected. Studies conducted in other stages of human development, exclusively or concurrently with the pediatric population; animal studies; literature review articles; dissertations and book chapters; and case studies and editorials were excluded. The data analysis was performed through a cataloging protocol created for this study, including the following points: author, research department, year, location, population/sample, age, purpose of the study, methods, and primary results. Results: 5613 items were found. 5307 were excluded based on title, 248 by abstract analysis, and 43 by full text evaluation. Fifteen articles were selected for analysis; of these, six were repeated articles, and thus nine articles were selected for review. Conclusion: The tests aiming at evaluation of taste were judiciously used, ensuring reliability for future research, which may employ methods similar to previous studies. .

Introdução: O paladar é de grande importância para o processo de alimentação. Visto dessa forma, torna-se fundamental a averiguação deste sentido junto às crianças, que são seres em desenvolvimento. Porém, apesar da pouca variação na utilização de testes que mensuram a capacidade gustatória, ainda existe questionamento acerca da aplicabilidade e do uso eficaz dos instrumentos de avaliação quantitativa, especificamente na população infantil. Objetivo: Levantar na literatura os instrumentos quantitativos para a avaliação do paladar utilizados em estudos com crianças. Método: Busca dos artigos realizada nas plataformas PUBMED e Web of Science, seguindo etapas de seleção e análise crítica dos periódicos encontrados. Os descritores e termos utilizados foram taste, child, assessment, diagnosis e dysgeusia. Foram selecionados artigos originais relacionados ao tema no idioma inglês, realizados somente com a população infantil e sem restrição de ano. Foram excluídos estudos realizados em outras fases do desenvolvimento humano, exclusivamente ou concomitantemente com a população infantil; estudos com animais; artigos de revisão de literatura, dissertações e capítulos de livros, artigos de estudo de caso e editoriais. A análise dos dados foi realizada por meio de um fichamento protocolar criado para este estudo, contemplando os seguintes pontos: autor, departamento de pesquisa, ano, local, população/amostra, idade, objetivo do estudo, métodos utilizados e resultados principais. Resultados: Foram encontrados 5613 artigos. Foram excluídos 5307 artigos pelo título, 248 pelo resumo e 43 pelo texto lido na íntegra. 15 manuscritos foram analisados, dos quais seis eram artigos repetidos. Assim, 9 artigos foram selecionados para esta revisão. Conclusão: Foi observada a utilização criteriosa dos testes de avaliação do paladar, garantindo confiabilidade às pesquisas futuras que venham a utilizar métodos semelhantes aos estudos já realizados. .

Quantitative evaluation of taste in childhood populations: a systematic review.

INTRODUCTION: Taste is of great importance for the feeding process. Seen in this light, it is essential to investigate this sense in children as developing human beings. However, despite little variation in the use of tests that measure the gustatory capacity, there are still questions about the applicability and effective use of tools for quantitative assessment in children. OBJECTIVE: To search the literature on quantitative instruments used for the evaluation of taste used in studies with children. METHODS: A search was conducted in the PUBMED and Web of Science platforms, and subsequently, the identified articles were selected and reviewed. The descriptors and terms used were "taste," "child," "assessment," "diagnosis," and "dysgeusia". Original articles related to the theme in English, restricted to children and with no year limitation, were selected. Studies conducted in other stages of human development, exclusively or concurrently with the pediatric population; animal studies; literature review articles; dissertations and book chapters; and case studies and editorials were excluded. The data analysis was performed through a cataloging protocol created for this study, including the following points: author, research department, year, location, population/sample, age, purpose of the study, methods, and primary results. RESULTS: 5613 items were found. 5307 were excluded based on title, 248 by abstract analysis, and 43 by full text evaluation. Fifteen articles were selected for analysis; of these, six were repeated articles, and thus nine articles were selected for review. CONCLUSION: The tests aiming at evaluation of taste were judiciously used, ensuring reliability for future research, which may employ methods similar to previous studies.

Gustatory and olfactory dysfunction in laryngectomized patients.

UNLABELLED: After total laryngectomy surgery, nasal airflow is moved permanently to the tracheostomy opening, compromising the contact of odorant molecules with the nasal cavity, which may reflect changes in the olfactory and gustatory perception in these individuals. OBJECTIVE: To evaluate the functions of smell and taste in total laryngectomized patients. STUDY DESIGN: a study of series. METHOD: The sample included a group of 25 patients submitted to total laryngectomy and another group of 25 patients who did not underwent the procedure. The taste function was evaluated by gustatory strips of filter paper. To assess the olfactory function we employed the Brief Smell Identification Test. RESULTS: Among the laryngectomized patients there was more hypogeusia (80%, p < 0.05), as well as hyposmia (88%, p < 0.001), alone and concomitant (72%, p < 0.001). Concerning flavor discrimination, the bitter taste did not differ between the groups - which was different from the other flavors. In the olfactory aspect, laryngectomized patients performed worse in detecting warning and food-related odors. We found that a history of smoking and alcohol consumption were significantly more frequent among laryngectomized patients. CONCLUSION: We found a decrease of gustatory and olfactory functions in total laryngectomized patients in this study.

Disfuncao gustatoria e olfatoria em laringectomizados / Gustatory and olfactory dysfunction in laryngectomized patients

Após a cirurgia de laringectomia total, o fluxo aéreo nasal é transferido definitivamente para o traqueostoma, comprometendo a chegada de moléculas odoríferas até a cavidade nasal, podendo repercutir em alterações na percepção olfatória e gustatória nesses indivíduos. OBJETIVO: Avaliar as funções do olfato e do paladar em laringectomizados totais. Desenho do estudo: Estudo de série. MÉTODO: A amostra envolveu um grupo com 25 pacientes submetidos à laringectomia total e outro grupo de comparação com 25 pacientes não laringectomizados. A função gustatória foi avaliada por tiras gustativas de papel de filtro. Para avaliação da função olfatória, foi aplicado o teste Brief Smell Identification Test. RESULTADOS: No grupo de laringectomizados, houve maior frequência de hipogeusia (80%; p < 0,05), assim como de hiposmia (88%; p < 0,001), isoladas e concomitantes (72%; p < 0,001). Na discriminação dos sabores, o sabor amargo não diferiu entre os grupos, diferentemente dos demais sabores. No aspecto olfatório, os laringectomizados tiveram pior desempenho na detecção de odores de alerta e os relacionados à alimentação. Identificou-se que história de tabagismo e de alcoolismo foi significantemente mais frequente dentre laringectomizados. CONCLUSÃO: A diminuição das funções olfatória e gustatória em laringectomizados totais foi evidenciada nesse estudo. .

After total laryngectomy surgery, nasal airflow is moved permanently to the tracheostomy opening, compromising the contact of odorant molecules with the nasal cavity, which may reflect changes in the olfactory and gustatory perception in these individuals. OBJECTIVE: To evaluate the functions of smell and taste in total laryngectomized patients. Study design: a study of series. METHOD: The sample included a group of 25 patients submitted to total laryngectomy and another group of 25 patients who did not underwent the procedure. The taste function was evaluated by gustatory strips of filter paper. To assess the olfactory function we employed the Brief Smell Identification Test. RESULTS: Among the laryngectomized patients there was more hypogeusia (80%, p < 0.05), as well as hyposmia (88%, p < 0.001), alone and concomitant (72%, p < 0.001). Concerning flavor discrimination, the bitter taste did not differ between the groups - which was different from the other flavors. In the olfactory aspect, laryngectomized patients performed worse in detecting warning and food-related odors. We found that a history of smoking and alcohol consumption were significantly more frequent among laryngectomized patients. CONCLUSION: We found a decrease of gustatory and olfactory functions in total laryngectomized patients in this study. .

The use of electrognathography in jaw movement research: a literature review.

The measurement of mandibular movements is a complex task that can be simplified through the use of electrognathography (EGN), an examination that can be applied as an auxiliary method for the diagnosis or follow-up of the evolution of specific therapeutics applied to the stomatognathic system. The aim of the present study was to review the literature pertaining to the use of EGN as a method for monitoring jaw movements in the research and treatments related to the stomathognathic system. A literature review was made by searching for articles in PubMED, MEDLINE (1997-2010), MEDLINE (1966-1996), LILACS, Ovid, BBO and SciELO databases. In this systematic review, 373 articles were found, of these, 23 articles were selected. The study concluded that EGN can be used with advantages in varied clinical situations, although it is a technique still not widely applied.

Reabilitação das funções do olfato e do paladar em laringectomizados totais: revisão sistemática / Rehabilitation of smell and taste functions in total laryngectomy: systematic review

TEMA: na laringectomia total ocorre a transferência do fluxo aéreo nasal definitivamente ao traqueostoma, podendo provocar diminuição na percepção do olfato e do paladar. Recentemente tem sido desenvolvidos métodos de intervenção a fim de melhorar a performance olfativa e gustativa em laringectomizados, embora sejam escassos os estudos que abordam esse tema. OBJETIVO: rever de forma sistemática as evidências de como as técnicas envolvidas na reabilitação das funções do olfato e do paladar tem efeito em indivíduos laringectomizados totais. CONCLUSÃO: nesta revisão todos os estudos selecionados demonstraram eficácia na utilização de técnicas de reabilitação para a função do olfato em laringectomizados totais. Para o paladar não houve propostas para intervir diretamente nesta função.

BACKGROUND: in total laryngectomy there occurs the transfer of the nasal airflow definitely to the tracheostoma, which could cause a decrease in the perception of smell and taste. There have been recently developed methods of intervention in order to improve performance in laryngectomized smell and taste, although few studies have investigated this issue. PURPOSE: this study aimed to systematically review the evidence of how the techniques involved in the rehabilitation of the functions of smell and taste have an effect on individuals with total laryngectomy. CONCLUSION: in this review all the selected studies demonstrated effective use of rehabilitation techniques for the role of olfaction in laryngectomized. As for taste, there were no proposals in order to intervene directly in this function.

O uso da medida canadense de desempenho ocupacional em estudos brasileiros: uma revisão sistemática / Using the Canadian occupational performance measure in Brazilian studies: a systematic review

O COPM caracteriza-se por ser uma medida individualizada, em que o sujeito auto-avalia as atividades mais im-portantes que se encontram em dificuldade em seu desempenho ocupacional. OBJETIVO: Revisar de forma sistemática estudos de pesquisadores brasileiros com a utilização da Medida Canadense de Desempenho Ocupacional como método avaliativo. PROCEDIMENTOS METODOLÓGICOS: A revisão sistemática foi realizada a partir das bases de dados PUBMED, MEDLINE (1997 - 2010), MEDLINE OLD (1966 - 1996), LILACS e SciELO. RESULTADOS: Foram encontrados 740 artigos a partir da busca de descritores e termo livre, sendo 278 da PUBMED, 340 da MEDLINE, 56 da MEDLINE OLD, 51 da LILACS, 15 da SciELO Brasil. Considerando os critérios de inclusão e de exclusão foram selecionados 06 artigos para esta revisão. CONCLUSÕES: No Brasil há escassez de estudos com a utilização deste método avaliativo, embora internacionalmente seja um importante guia da prática clínica de terapeutas ocupacionais.

The COPM is characterized by a measure to be individualized, in which the subject self-assessment the activities most important that are in difficulty in their occupational performance. OBJECTIVE: Systematically review studies of Brazilian researchers using the Canadian Occupational Performance Measure as evaluation method. METHODOLOGICAL PROCEDURES: A systematic review was performed from the PUBMED, MEDLINE (1997 - 2010), MEDLINE OLD (1966 - 1996), LILACS and SciELO. RESULTS: There were 740 articles from the search term descriptors and free, and 278 of the PUBMED, 340 of the MEDLINE, 56 of the MEDLINE OLD, 51 of the LILACS, 15 of the SCIELO Brazil. Considering the criteria for inclusion and exclusion of 06 articles were selected for this review. CONCLUSIONS: In Brazil there are few studies using this evaluation method, although internationally is an important guide for clinical practice of occupational therapists.

Modifications and evaluation of smell and taste functions in total laryngectomy: systematic review.

The aim of this study was to systematically review the alterations in smell and taste functions in individuals who underwent total laryngectomy, as well as to identify in the literature some aspects involved in the evaluation of these functions in this population. We performed a systematic review on the databases Medline, LILACS and SciELO, and this data search occurred in October/2010. The search used keywords and free terms, and retrieved 84 articles, 79 from Medline, via Pubmed, and five form LILACS and SciELO. Sixteen of these articles were selected. Most studies in this review attested decline in sensory of smell and taste functions in individuals who underwent total laryngectomy and, although there is consensus regarding the damage caused to these functions by the nasal airflow interruption, it is not yet possible to evidence details in the mechanisms and structures involved, especially regarding the modifications in the olfactory mucous.

Alterações e avaliação das funções do olfato e do paladar em laringectomizados totais: revisão sistemática / Modifications and evaluation of smell and taste functions in total laryngectomy: systematic review

O objetivo desse estudo foi rever de forma sistemática as alterações nas funções do olfato e do paladar em indivíduos submetidos à laringectomia total, bem como identificar na literatura os aspectos envolvidos na avaliação dessas funções nesta população. Foi realizada uma revisão sistemática a partir das bases de dados MedLine, LILACS e SciELO, tendo a busca de dados ocorrida em outubro/2010. Foram encontrados 84 artigos a partir da busca de descritores e termo livre, sendo 79 da Medline, via Pubmed, e cinco da LILACS e da SciELO. Destes, foram selecionados 16 artigos. A maioria dos estudos, nesta revisão, atestou diminuição das funções sensoriais do olfato e do paladar em indivíduos submetidos à laringectomia total e, embora haja consenso com relação aos prejuízos causados a essas funções pela interrupção do fluxo aéreo nasal, ainda não é possível evidenciar minuciosamente os mecanismos e estruturas envolvidas, principalmente no que se refere às alterações da mucosa olfatória.

The aim of this study was to systematically review the alterations in smell and taste functions in individuals who underwent total laryngectomy, as well as to identify in the literature some aspects involved in the evaluation of these functions in this population. We performed a systematic review on the databases Medline, LILACS and SciELO, and this data search occurred in October/2010. The search used keywords and free terms, and retrieved 84 articles, 79 from Medline, via Pubmed, and five form LILACS and SciELO. Sixteen of these articles were selected. Most studies in this review attested decline in sensory of smell and taste functions in individuals who underwent total laryngectomy and, although there is consensus regarding the damage caused to these functions by the nasal airflow interruption, it is not yet possible to evidence details in the mechanisms and structures involved, especially regarding the modifications in the olfactory mucous.