Hand Function in Muscular Dystrophies.

The aim of this study was to investigate the relationship between Performance of Upper Limb (PUL) and Jebsen-Taylor Test (JTT) to assess and monitor upper limb function progression in patients with muscular dystrophy. Thirty patients diagnosed with Duchenne muscular dystrophy, limb-girdle muscular dystrophy, Becker muscular dystrophy, myotonic dystrophy Type 1, and fascioscapulohumeral dystrophy were submitted to the shoulder, elbow, and wrist domains of PUL, and to JTT subtests. Spearman tests investigated the relationships between PUL and JTT total scores and domains. Correlations were classified as strong ( r ≥ 0.70), moderate (0.40 ≤ r < 0.70), or weak ( r ≤ 0.40). There were strong correlations between the PUL and JTT total scores ( r = -0.706). Although JTT measures time and PUL provides kinesiologic scores, these measures were related. Therefore, muscle synergies, which control the compensatory movements and motor functions involving mainly shoulder, elbow, wrist, and finger movements, are related to timed performance in patients with muscular dystrophies.

Responsiveness of the domain climbing up and going down stairs of the Functional Evaluation scale for Duchenne Muscular Dystrophy: a one-year follow-up

ABSTRACT Objective: To determine the responsiveness of the domain climbing up and going down stairs of the Functional Evaluation Scale for Duchenne Muscular Dystrophy (FES-DMD-D3) in a one-year follow-up study. Method: The study included 26 patients with DMD. Effect Size (ES) and Standardized Response Mean (SRM) described the scale’s responsiveness. Results: For climbing up stairs, ES showed that responsiveness was low in the three-month assessments (0.26; 0.35; 0.13; 0.17), low to moderate in the six-month assessments (0.58; 0.48; 0.33), moderate in the nine-month assessments (0.70; 0.68), and high in the 12-month assessment (0.88). SRM showed that responsiveness was low in the three-month assessments (0.29; 0.38; 0.18; and 0.19), low to moderate in the six-month assessments (0.59; 0.51; 0.36), moderate in the nine-month assessments (0.74 and 0.70), and high in the 12-month assessment (0.89). For going down stairs, ES showed that responsiveness was low in the three- and six-month assessments (0.16; 0.25; 0.09; 0.08 and 0.48; 0.35; 0.18, respectively), low to moderate in the nine-month assessments (0.59; 0.44), and moderate in the 12-month assessment (0.71). SRM showed that responsiveness was low in the three- and six-month assessments (0.25; 0.35; 0.12; 0.09 and 0.47; 0.38; 0.21, respectively), low to moderate in the nine-month assessment (0.62; 0.49), and moderate in the 12-month assessment (0.74). Conclusion: Climbing up stairs should be assessed at intervals of nine months or longer, when responsiveness is moderate to high. Going down stairs should be assessed annually because moderate responsiveness was observed in this period.

Relationship between muscle strength and motor function in Duchenne muscular dystrophy.

OBJECTIVE: To investigate the relationship between muscle strength and motor function and between these variables and age. METHOD: Muscle strength was measured by Medical Research Council (MRC) scale and motor function, by Motor Function Measure (MFM), in 40 non-ambulatory patients. Spearman tests investigated the relationships between muscle strength, motor function and age. RESULTS: Total MRC and MFM scores were strongly related to each other (r = 0.94; p < 0.001), but not to age (r = -0.19, r = -0.31, respectively; p > 0.05). Strong and moderate relationships between partial muscle strength and motor function scores were found. Higher correlation coefficients were found between total scores and Dimensions 2 (axial/ proximal control) and 3 (distal control) of MFM. CONCLUSION: Muscle strength and motor function are strongly correlated and seem to decrease proportionally in DMD.

Relationship between muscle strength and motor function in Duchenne muscular dystrophy / Relação entre força muscular e função motora na distrofia muscular de Duchenne

ABSTRACT Measuring muscle strength and motor function is part of Duchenne muscular dystrophy (DMD) assessment. However, the relationship between these variables is controversial. Objective To investigate the relationship between muscle strength and motor function and between these variables and age. Method Muscle strength was measured by Medical Research Council (MRC) scale and motor function, by Motor Function Measure (MFM), in 40 non-ambulatory patients. Spearman tests investigated the relationships between muscle strength, motor function and age. Results Total MRC and MFM scores were strongly related to each other (r = 0.94; p < 0.001), but not to age (r = -0.19, r = -0.31, respectively; p > 0.05). Strong and moderate relationships between partial muscle strength and motor function scores were found. Higher correlation coefficients were found between total scores and Dimensions 2 (axial/ proximal control) and 3 (distal control) of MFM. Conclusion Muscle strength and motor function are strongly correlated and seem to decrease proportionally in DMD.

RESUMO Mensurar força muscular e função motora é parte da avaliação em distrofia muscular de Duchenne (DMD). A relação entre essas variáveis é controversa. Objetivo Investigar a relação entre força muscular, função motora e idade. Método Força muscular foi medida pela Medical Research Council (MRC), e função motora pela escala Medida da Função Motora (MFM), em 40 pacientes cadeirantes. Teste de Spearman investigou as relações entre força muscular, função motora e idade. Resultados O escore total da escala MRC e da MFM foram fortemente relacionados entre si (r = 0,94; p < 0,001), mas não com a idade (r = -0,19; r = -0,31, respectivamente; p > 0,05). Foram encontradas correlações fortes e moderadas entre os escores parciais de força muscular e função motora. As relações mais fortes ocorreram entre os escores totais, Dimensão 2 (controle axial/proximal) e 3 (controle distal) da escala MFM. Conclusão Força muscular e função motora estão fortemente correlacionadas e parecem diminuir proporcionalmente na DMD.

Responsiveness of the domain climbing up and going down stairs of the Functional Evaluation scale for Duchenne Muscular Dystrophy: a one-year follow-up.

OBJECTIVE:: To determine the responsiveness of the domain climbing up and going down stairs of the Functional Evaluation Scale for Duchenne Muscular Dystrophy (FES-DMD-D3) in a one-year follow-up study. METHOD:: The study included 26 patients with DMD. Effect Size (ES) and Standardized Response Mean (SRM) described the scale's responsiveness. RESULTS:: For climbing up stairs, ES showed that responsiveness was low in the three-month assessments (0.26; 0.35; 0.13; 0.17), low to moderate in the six-month assessments (0.58; 0.48; 0.33), moderate in the nine-month assessments (0.70; 0.68), and high in the 12-month assessment (0.88). SRM showed that responsiveness was low in the three-month assessments (0.29; 0.38; 0.18; and 0.19), low to moderate in the six-month assessments (0.59; 0.51; 0.36), moderate in the nine-month assessments (0.74 and 0.70), and high in the 12-month assessment (0.89). For going down stairs, ES showed that responsiveness was low in the three- and six-month assessments (0.16; 0.25; 0.09; 0.08 and 0.48; 0.35; 0.18, respectively), low to moderate in the nine-month assessments (0.59; 0.44), and moderate in the 12-month assessment (0.71). SRM showed that responsiveness was low in the three- and six-month assessments (0.25; 0.35; 0.12; 0.09 and 0.47; 0.38; 0.21, respectively), low to moderate in the nine-month assessment (0.62; 0.49), and moderate in the 12-month assessment (0.74). CONCLUSION:: Climbing up stairs should be assessed at intervals of nine months or longer, when responsiveness is moderate to high. Going down stairs should be assessed annually because moderate responsiveness was observed in this period.

Relationship between the climbing up and climbing down stairs domain scores on the FES-DMD, the score on the Vignos Scale, age and timed performance of functional activities in boys with Duchenne muscular dystrophy / Relação entre escore FES-DMD-subir e descer escada com escore Escala Vignos, idade e tempo de realização das atividades em meninos com Distrofia Muscular de Duchenne

BACKGROUND: Knowing the potential for and limitations of information generated using different evaluation instruments favors the development of more accurate functional diagnoses and therapeutic decision-making. OBJECTIVE: To investigate the relationship between the number of compensatory movements when climbing up and going down stairs, age, functional classification and time taken to perform a tested activity (TA) of going up and down stairs in boys with Duchenne muscular dystrophy (DMD). METHOD: A bank of movies featuring 30 boys with DMD performing functional activities was evaluated. Compensatory movements were assessed using the climbing up and going down stairs domain of the Functional Evaluation Scale for Duchenne Muscular Dystrophy (FES-DMD); age in years; functional classification using the Vignos Scale (VS), and TA using a timer. Statistical analyses were performed using the Spearman correlation test. RESULTS: There is a moderate relationship between the climbing up stairs domain of the FES-DMD and age (r=0.53, p=0.004) and strong relationships with VS (r=0.72, p=0.001) and TA for this task (r=0.83, p<0.001). There were weak relationships between the going down stairs domain of the FES-DMD-going down stairs with age (r=0.40, p=0.032), VS (r=0.65, p=0.002) and TA for this task (r=0.40, p=0.034). CONCLUSION: These findings indicate that the evaluation of compensatory movements used when climbing up stairs can provide more relevant information about the evolution of the disease, although the activity of going down stairs should be investigated, with the aim of enriching guidance and strengthening accident prevention. Data from the FES-DMD, age, VS and TA can be used in a complementary way to formulate functional diagnoses. Longitudinal studies and with broader age groups may supplement this information. .

CONTEXTUALIZAÇÃO: Conhecer as potencialidades e limitações das informações geradas por diferentes instrumentos de avaliação favorece o desenvolvimento mais preciso do diagnóstico funcional e da tomada de decisão terapêutica. OBJETIVO : Investigar a relação entre o número de movimentos compensatórios ao subir e descer escadas, idade, classificação funcional e tempo de realização de atividade (TA) em meninos com Distrofia Muscular de Duchenne (DMD). MÉTODO : Foi utilizado banco de filmes de 30 meninos com DMD realizando atividades funcionais. Os movimentos compensatórios foram avaliados pela Escala de Avaliação Funcional para Distrofia Muscular de Duchenne (FES-DMD), domínio subir e descer escada; a idade, mensurada em anos; a classificação funcional foi pesquisada pela Escala de Vignos (EV), e o TA foi cronometrado. Foi utilizado o teste de correlação de Spearman. RESULTADOS : Existe moderada relação entre a FES-DMD-subir escada e a idade (r=0,53, p=0,004) e forte relação com a EV (r=0,72, p=0,001) e TA dessa tarefa (r=0,83, p<0,001). Houve fraca relação entre a FES-DMD-descer escada e a idade (r=0,40, p=0,032), EV (r=0,65, p=0,002) e o TA dessa tarefa (r=0,40, p=0,034). CONCLUSÃO : Esses achados indicam que a avaliação da tarefa de subir escada pode trazer informações mais relevantes sobre a evolução da doença, embora a atividade de descer escada deva ser pesquisada visando à orientação e prevenção de acidentes. A utilização conjunta de dados provenientes da FES-DMD, da idade e do TA pode se complementar para formulação do diagnóstico funcional. Estudos longitudinais e com outras faixas etárias mais amplas podem complementar tal informação. .

Relationship between the climbing up and climbing down stairs domain scores on the FES-DMD, the score on the Vignos Scale, age and timed performance of functional activities in boys with Duchenne muscular dystrophy.

BACKGROUND: Knowing the potential for and limitations of information generated using different evaluation instruments favors the development of more accurate functional diagnoses and therapeutic decision-making. OBJECTIVE: To investigate the relationship between the number of compensatory movements when climbing up and going down stairs, age, functional classification and time taken to perform a tested activity (TA) of going up and down stairs in boys with Duchenne muscular dystrophy (DMD). METHOD: A bank of movies featuring 30 boys with DMD performing functional activities was evaluated. Compensatory movements were assessed using the climbing up and going down stairs domain of the Functional Evaluation Scale for Duchenne Muscular Dystrophy (FES-DMD); age in years; functional classification using the Vignos Scale (VS), and TA using a timer. Statistical analyses were performed using the Spearman correlation test. RESULTS: There is a moderate relationship between the climbing up stairs domain of the FES-DMD and age (r=0.53, p=0.004) and strong relationships with VS (r=0.72, p=0.001) and TA for this task (r=0.83, p<0.001). There were weak relationships between the going down stairs domain of the FES-DMD-going down stairs with age (r=0.40, p=0.032), VS (r=0.65, p=0.002) and TA for this task (r=0.40, p=0.034). CONCLUSION: These findings indicate that the evaluation of compensatory movements used when climbing up stairs can provide more relevant information about the evolution of the disease, although the activity of going down stairs should be investigated, with the aim of enriching guidance and strengthening accident prevention. Data from the FES-DMD, age, VS and TA can be used in a complementary way to formulate functional diagnoses. Longitudinal studies and with broader age groups may supplement this information.

Thoracic cirtometry in children with Duchenne muscular dystrophy--expansion of the method.

BACKGROUND: Thoracic cirtometry is a simple and accessible technique to evaluate chest mobility during forced breathing. However, it does not allow for the assessment of compensatory movements commonly used by people with chronic diseases, such Duchenne muscular dystrophy (DMD). DMD is a condition characterized by progressive and irreversible degeneration of the musculoskeletal system. OBJECTIVES: To expand the method of thoracic cirtometry to allow for the assessment of compensatory movements; to analyze the reliability of the tool; and to describe thoracic mobility of children with DMD during deep breathing. METHOD: Sixty boys, 30 with DMD (10.1±0.5 years) and 30 healthy controls (9.5±0.6 years) participated in the study. The expanded thoracic cirtometry was organized in two phases: 1. the body could move freely, allowing the assessment of compensatory movements (free thoracic cirtometry) and 2. the body without compensatory movements, allowing for the direct study of the movements of the chest (guided thoracic cirtometry). This method includes videotaping and systematic observation of body movements using descriptive and numeric data. We investigated reliability of these measures in both groups. RESULTS: Measures of axial and the xiphoid thoracic cirtometry (both free and guided) showed excellent reliability. All measures were significantly different between groups. In DMD boys, free thoracic cirtometry presented a greater value of chest expansion when compared with the guided measures, which probably occurred due to compensatory movements. The most commons were movements of the head, shoulder and torso. CONCLUSIONS: The expanded thoracic cirtometry method showed excellent reliability and achieved the objectives of determining measures of chest mobility and compensatory movements during deep breath. We suggested its use in the respiratory evaluation of children with DMD.

Thoracic cirtometry in children with Duchenne muscular dystrophy: expansion of the method / Toracometria em crianças com Distrofia Muscular de Duchenne: expansão do método

BACKGROUND: Thoracic cirtometry is a simple and accessible technique to evaluate chest mobility during forced breathing. However, it does not allow for the assessment of compensatory movements commonly used by people with chronic diseases, such Duchenne muscular dystrophy (DMD). DMD is a condition characterized by progressive and irreversible degeneration of the musculoskeletal system. OBJECTIVES: To expand the method of thoracic cirtometry to allow for the assessment of compensatory movements; to analyze the reliability of the tool; and to describe thoracic mobility of children with DMD during deep breathing. METHOD: Sixty boys, 30 with DMD (10.1±0.5 years) and 30 healthy controls (9.5±0.6 years) participated in the study. The expanded thoracic cirtometry was organized in two phases: 1. the body could move freely, allowing the assessment of compensatory movements (free thoracic cirtometry) and 2. the body without compensatory movements, allowing for the direct study of the movements of the chest (guided thoracic cirtometry). This method includes videotaping and systematic observation of body movements using descriptive and numeric data. We investigated reliability of these measures in both groups. RESULTS: Measures of axial and the xiphoid thoracic cirtometry (both free and guided) showed excellent reliability. All measures were significantly different between groups. In DMD boys, free thoracic cirtometry presented a greater value of chest expansion when compared with the guided measures, which probably occurred due to compensatory movements. The most commons were movements of the head, shoulder and torso. CONCLUSIONS: The expanded thoracic cirtometry method showed excellent reliability and achieved the objectives of determining measures of chest mobility and compensatory movements during deep breath. We suggested its use in the respiratory evaluation of children with DMD.

CONTEXTUALIZAÇÃO: A toracometria é um método simples e acessível para avaliar a mobilidade do tórax durante uma respiração forçada, mas não permite pesquisar os movimentos compensatórios utilizados por portadores de doenças crônicas, como Distrofia Muscular de Duchenne (DMD), caracterizada pela degeneração progressiva e irreversível da musculatura esquelética. OBJETIVOS: Ampliar método de avaliação pela toracometria, permitindo avaliação dos movimentos compensatórios; analisar a confiabilidade da ferramenta e descrever a mobilidade torácica de crianças com DMD durante respiração profunda. MÉTODO: Participaram 60 meninos, 30 com DMD (10,1±0,5 anos) e 30 saudáveis (9,5±0,6 anos). Organizou-se método de toracometria expandida em duas fases: livre movimentação corporal, permitindo avaliação de movimentos compensatórios (toracometria livre) e movimentação corporal sem movimentos compensatórios, permitindo o estudo dirigido aos movimentos do gradil costal (toracometria dirigida). Esse método prevê filmagem e observação sistemática dos movimentos, gerando dados numéricos e descritivos. O estudo de confiabilidade foi realizado para os dois grupos. RESULTADOS: As medidas de toracometria axial e xifoide (livres e dirigidas) apresentaram excelente confiabilidade. As medidas apresentaram diferenças significantes entre os grupos. Nas crianças com DMD, a toracometria livre apresentou valor de expansibilidade torácica maior quando comparada com a toracometria dirigida, provavelmente decorrente do auxílio dos movimentos compensatórios, sendo observados com maior frequência os associados à cabeça, ombro e tronco. CONCLUSÕES: O método de toracometria expandida apresentou excelente confiabilidade e permitiu descrever os movimentos compensatórios e da caixa torácica durante respiração profunda. Sugere-se sua utilização na avaliação respiratória de crianças com DMD.

Elaboração e confiabilidade da escala funcional do subir e do descer escada para Distrofia Muscular de Duchenne / Elaboration and reliability of functional evaluation on going up and downstairs scale for Duchenne Muscular Dystrophy

CONTEXTUALIZAÇÃO: Os instrumentos de avaliação funcional utilizados para pacientes com distrofia muscular de Duchenne (DMD), citados na literatura, são limitados e escassos, dificultando a tomada de decisão clínica fisioterapêutica. OBJETIVOS: Descrever o processo de criação de uma escala de avaliação funcional do subir e do descer escadas, específica para crianças com diagnóstico de DMD, e examinar sua confiabilidade inter e intraexaminadores. MÉTODOS: A construção da escala seguiu cinco etapas, a saber, elaboração de um roteiro para observação dirigida com base na literatura; observação do subir e do descer em 120 registros filmados de 30 crianças com DMD (5 a 11 anos); elaboração da escala, considerando o grau crescente de dificuldade de execução dos movimentos; criação do manual de preenchimento e submissão da escala e do manual a 10 examinadores, seguida de reajustes para criação da versão final. A confiabilidade foi testada pelo pesquisador (repetibilidade) e dois examinadores independentes (reprodutibilidade). Utilizou-se o Índice de Correlação Intra-Classe (ICC) e a Correlação de Kappa Ponderado. RESULTADOS: A escala elaborada abrange cinco fases para o subir e quatro fases para o descer escadas. Encontrou-se excelente confiabilidade intra/interexaminadores, com valores da Correlação de Kappa Ponderado > 0,78 em todas as fases e ICCs > 0,89, com p<0,05 entre todos os escores. CONCLUSÃO: A escala proposta mostrou excelente repetibilidade e reprodutibilidade, sendo necessária a continuidade do estudo com os objetivos de avaliar sua acurácia e validade e de construir uma ferramenta digital para otimizar a coleta de dados.

BACKGROUND: Instruments of functional evaluation for patients with Duchenne Muscular Dystrophy (DMD), available from the literature, are limited and scarce, making clinical decision on Physiotherapy difficulty. OBJECTIVES: To describe the process of creating a functional assessment scale in patients with DMD while going up and down the stairs, as well as to analyse the intra and inter-rater reliability of this scale. METHODS: The scale development consisted of five stages: 1) to elaborate a script for directed observation based upon literature, 2) to describe a sequence of movements assessing 120 video recordings from 30 children (from 5 to 11 years) with DMD while going up and down stairs, 3) to elaborate a scale considering the degree of difficulty to execute the movements, 4) to create handbook, and 5) to submit both the scale and the handbook to be assess by 10 examiners, and review to create the final version. Both repeatability (researcher) and reproducibility (two independent examiners) were tested by using the IntraClass Correlation Coefficient (ICC) and Weighted Kappa respectively. RESULTS: The scale encloses five phases for going up and four phases for going downstairs. Our results showed both excellent intra and intertester reliability, with values of Weighted Kappa > 0.78 in all phases and ICCs > 0.89, with p<0.05 for all scores. CONCLUSION: The proposed scale showed excellent repeatability and reproducibility, requiring continuing the studies to assess its accuracy, validity and to create digital tools to improve data collection.

Elaboration and reliability of functional evaluation on going up and downstairs scale for Duchenne Muscular Dystrophy.

BACKGROUND: Instruments of functional evaluation for patients with Duchenne Muscular Dystrophy (DMD), available from the literature, are limited and scarce, making clinical decision on Physiotherapy difficulty. OBJECTIVES: To describe the process of creating a functional assessment scale in patients with DMD while going up and down the stairs, as well as to analyse the intra and inter-rater reliability of this scale. METHODS: The scale development consisted of five stages: 1) to elaborate a script for directed observation based upon literature, 2) to describe a sequence of movements assessing 120 video recordings from 30 children (from 5 to 11 years) with DMD while going up and down stairs, 3) to elaborate a scale considering the degree of difficulty to execute the movements, 4) to create handbook, and 5) to submit both the scale and the handbook to be assess by 10 examiners, and review to create the final version. Both repeatability (researcher) and reproducibility (two independent examiners) were tested by using the IntraClass Correlation Coefficient (ICC) and Weighted Kappa respectively. RESULTS: The scale encloses five phases for going up and four phases for going downstairs. Our results showed both excellent intra and intertester reliability, with values of Weighted Kappa > 0.78 in all phases and ICCs > 0.89, with p<0.05 for all scores. CONCLUSION: The proposed scale showed excellent repeatability and reproducibility, requiring continuing the studies to assess its accuracy, validity and to create digital tools to improve data collection.

Manutenção na prática de exercícios por idosos / Exercise maintenance among older adults

Este estudo investigou a contribuição de dois programas de treinamento físico para a manutenção na prática de exercícios físicos em idosos. Vinte idosos tiveram seu desempenho físico testado (T1) e posteriormente foram randomizados em dois grupos de 10 indivíduos. O G A realizou exercícios gerais. O G B participou de um programa de caminhada. Após 16 semanas de intervenção, todos foram reavaliados (T2). Após um ano de T2, foram novamente avaliados (T3) e também responderam uma entrevista a respeito da manutenção da prática de atividade física. Ambos grupos apresentaram melhora no desempenho físico e os achados foram compatíveis com as atividades referidas na entrevista. Em T3, sete dos nove participantes do G A mantiveram suas rotinas de atividade física. No G B, oito dos dez o fizeram. A manutenção aumentou ou preservou o desempenho físico, enquanto o abandono o piorou. O treinamento parece modificar o comportamento da população estudada quanto à prática de exercícios.(AU)

This study aims to investigate the effects of 2 physical training programs in the physical exercises practice maintenance in elderly persons. Twenty elderly persons had their physical performance assessed (T1). Later, subjects were randomized in two groups, with ten each. Group A performed general exercises and group B performed a program with walking exercises. After 16 weeks of intervention, subjects were assessed once again (T2). One year after T2, subjects were assessed one more time (T3). In T3, subjects also answered an interview about physical activity practical maintenance. Both training interventions improved physical performance, in agree with the answers of the interview. In T3, seven of nine subjects from group A kept their exercises routines. In group B, eight of ten subjects kept the routines. Maintenance increased or preserved the physical performance, while the abandonment got it worse. Training seems to modify the population studied behavior to the exercise practice.(AU)

Manutenção na prática de exercícios por idosos / Exercise maintenance among older adults

Este estudo investigou a contribuição de dois programas de treinamento físico para a manutenção na prática de exercícios físicos em idosos. Vinte idosos tiveram seu desempenho físico testado (T1) e posteriormente foram randomizados em dois grupos de 10 indivíduos. O G A realizou exercícios gerais. O G B participou de um programa de caminhada. Após 16 semanas de intervenção, todos foram reavaliados (T2). Após um ano de T2, foram novamente avaliados (T3) e também responderam uma entrevista a respeito da manutenção da prática de atividade física. Ambos grupos apresentaram melhora no desempenho físico e os achados foram compatíveis com as atividades referidas na entrevista. Em T3, sete dos nove participantes do G A mantiveram suas rotinas de atividade física. No G B, oito dos dez o fizeram. A manutenção aumentou ou preservou o desempenho físico, enquanto o abandono o piorou. O treinamento parece modificar o comportamento da população estudada quanto à prática de exercícios.

This study aims to investigate the effects of 2 physical training programs in the physical exercises practice maintenance in elderly persons. Twenty elderly persons had their physical performance assessed (T1). Later, subjects were randomized in two groups, with ten each. Group A performed general exercises and group B performed a program with walking exercises. After 16 weeks of intervention, subjects were assessed once again (T2). One year after T2, subjects were assessed one more time (T3). In T3, subjects also answered an interview about physical activity practical maintenance. Both training interventions improved physical performance, in agree with the answers of the interview. In T3, seven of nine subjects from group A kept their exercises routines. In group B, eight of ten subjects kept the routines. Maintenance increased or preserved the physical performance, while the abandonment got it worse. Training seems to modify the population studied behavior to the exercise practice.

Fundamentos da hidroterapia para idosos / Foundations of the hydrotherapy for senior

Este artigo apresenta os fundamentos básicos a serem considerados pelo fisioterapeuta durante a decisão de indicação de hidroterapia para pacientes idosos com diferentes históricos clínicos e funcionais. O artigo está dividido em 4 partes que abordam as perdas funcionais decorrentes do processo de envelhecimento; os efeitos fisiológicos decorrentes da imersão de um corpo na água; os efeitos do exercício físico realizado em imersão na água; as considerações finais sobre a realização de exercícios físicos na água para pessoas idosas, discutindo as vantagens desta modalidade de terapêutica