Adherence rate, barriers to attend, safety and overall experience of a physical exercise program via telemonitoring during COVID-19 pandemic for individuals with Parkinson's disease: A feasibility study.

BACKGROUND: Telemonitoring can maintain daily exercise routine during the COVID-19 pandemic of individuals with Parkinson's disease (PD). However, there are barriers to adherence and attendance with remote physical rehabilitation. The main objective of this study was to evaluate adherence rate, barriers to attendance, and safety of a telemonitoring program for individuals with PD; and secondarily to evaluate the individual and their family members perceived overall experience when performing the telemonitoring physical exercise program. METHODS: This was a phase 1 of a clinical trial, engaging 19 individuals with idiopathic PD of an in-person community rehabilitation program. For 24 weeks an asynchronous telemonitoring physical exercise program delivered two sessions per week by video including warm-up, balance, aerobic and resistance exercises, and cool-down. During the remote program were verified: adherence rate at entrance, attendance rate, barriers to attend, safety, and overall experience of the program. RESULTS AND CONCLUSION: Only one participant did not perform any session and 18 participants completed between 2 and 34 sessions. Participants with a caregiver showed higher attendance rates. The most frequently cited barriers to attend the program were: pain; lack of motor skills; and reduced physical fitness. In relation to safety of the program, the most frequently reported was fear of falling. Although participants reported the telemonitoring program induced health benefits and they had positive experiences for themselves and for their families, most of participants prefer an in-person program. In this sense, the asynchronous telemonitoring physical exercise program was safe, showed moderate adherence, with attendance rate depending on the presence of a companion.

Effects of the brain-damaged side after stroke on the learning of a balance task in a non-immersive virtual reality environment.

Background: Post-stroke survivors with right hemisphere injury have more impairments in postural control and balance. However, the impact of the hemisphere injured on the process of balance reacquisition has not been fully explored. We hypothesized that stroke survivors could learn balance tasks (H1), but right hemisphere damaged patients would show poor motor learning if compared to left hemisphere damaged patients (H2)Objective: To investigate whether the brain-damaged side after stroke affects the learning of a balance task. Methods: Three groups were recruited: twenty stroke survivors (ten left and ten right hemisphere damage) and twenty healthy volunteers. The participants practiced a balance task for thirty minutes, four consecutive days. The task was the Table Tilt game (NintendoTM Company), which induces balance demands with a progression of complexity. Motor performance was assessed at baseline, post-practice and after one week (retention test). Accuracy, errors, and complexity of the task achieved during the trial were assessedResults: Participants in all groups improved their performance (p < .001) and maintained it at the retention test. The control group showed better performance if compared to the right and left hemisphere damaged stroke survivors (p < .05). There was no difference between individuals with right and left hemisphere damaged, but the right hemisphere damaged patients demonstrated more errors at higher levels of complexityConclusion: Stroke survivors can learn balance tasks (H1), and the right hemisphere damaged patients demonstrate more errors than those with left hemisphere injury in higher complexity conditions (H2).

The role of nocturnal sleep on the retention, adaptability, and relearning rate of a motor skill

Abstract Aim: The influence of sleep on the adaptability and relearning rate during learning of complex motor skills is still unknown, limiting the comprehension of the sleep role in motor memory consolidation. Thus, we aimed to investigate the nocturnal sleep influence on retention, adaptability, and relearning rate of the dart-throwing task. Methods: Sixty healthy adults were divided into two groups: SLEEP and WAKE. Both groups practiced an under-arm dart-throwing task. However, WAKE practiced in the morning and performed a retention phase in the evening, and SLEEP practiced in the evening and performed a retention phase in the morning of the next day. The practice and retention phases were separated by 12 h in both groups. There were analyses regarding retention (retention test), adaptability (delayed transfer test), and relearning rate (savings). Results: Both groups improved their performance across the acquisition phase and maintained it in the retention test. The groups did not demonstrate adaptability and did not demonstrate a significant difference in relearning rate. Conclusion: We conclude that nocturnal sleep did not modulate the consolidation of motor memories related to ballistic discrete motor skills.

Adherence Rate, Barriers to Attend, Safety, and Overall Experience of a Remote Physical Exercise Program During the COVID-19 Pandemic for Individuals After Stroke.

Introduction: The actions taken by the government to deal with the consequences of the coronavirus diseases 2019 (COVID-19) pandemic caused different levels of restriction on the mobility of the population. The need to continue offering physical exercise to individuals after stroke became an emergency. However, these individuals may have barriers to adhere to the programs delivered remotely. There is a lack of evidence related to adherence, attendance, safety, and satisfaction of remote exercise programs for this population. Objective: The aim was to evaluate adherence and barriers to attend a remote physical exercise program for individuals after stroke. We aimed (a) to identify adherence and attendance rate of the remote physical exercise program (i.e., number of participants engaged, number of sessions attended, and exercise time in remote program); (b) to identify the safety of a remote physical exercise program (i.e., falls, pain, or dizziness when performing the exercises, fear, or insecurity); and (c) to identify the overall experience to participate in a remote program. Materials and methods: This is a longitudinal study, including 36 stroke survivors who already attended a face-to-face physical exercise program prior to the COVID-19 pandemic. The remote physical exercise program included sessions for 2 days/week for a duration of 22 weeks, with a total of 44 sessions, which were delivered asynchrony via recorded video sessions. As outcome measures, we performed two questionnaires (via weekly telephone calls) to identify attendance, barriers, safety, and overall experience related to the program. Results: The adherence rate was 86 (9%). The attendance rate was 19, with a total of 8 sessions (108.3 min/week). The main barriers for lower attendance rate were as follows: lack of motor skills and physical fitness to workout in 80 reports (20.6%), followed by no exercise companion in 44 reports (11.3%). The remote physical program has been shown to be safe, and the overall experience was positive from the perspectives of the participants and the family members. Conclusion: Although the adherence rate was high, the attendance rate was low on the remote physical exercise program. The main barriers to attending the program remotely reflect the need of tailoring individually an asynchrony mode of delivering the sessions to individuals after stroke. Our results also indicate how the COVID-19 impacted the health conditions of stroke survivors. The program was safe, and the overall experience indicated a change in the mental, physical, and social health of individuals after stroke and their family members.

The anticipatory and reaction time behaviors of the futsal goalkeeper / Os comportamentos antecipatório e de tempo de reação do goleiro do futsal

ABSTRACT This study aimed to investigate the goalkeeper's anticipatory and reaction time behaviors. For this purpose, 50 kicks performed by male futsal players were analyzed. The time of goalkeeper's response to a kick was analyzed in relation to the kick outcome, court zone and distance between the goalkeeper and player who performed the kick. The goalkeeper's anticipation and reaction time behaviors were those below and above 200 ms as the time criterion, respectively, by considering the moment the player began the preparation for kicking to the moment the goalkeeper began to respond to it. Results showed that the goalkeeper performed anticipatory behaviors predominantly when (i) goals were attained and (ii) kicks were performed in the center and attack court's zones (iii) at a distance ranging from 5.97 to 7.84 meters. In these conditions, the goalkeepers' anticipatory behaviors implied ineffective performances.

RESUMO Este estudo teve como objetivo investigar os comportamentos antecipatório e de tempo de reação do goleiro. Para este fim foram analisados 50 chutes executados por jogaores de futsal. O tempo de resposta do goleiro a um chute foi analisado em relação ao resultado do chute, à zona da quadra e à distância entre o goleiro e o jogador que executou o chute. Os comportamentos de antecipação e tempo de reação do goleiro foram considerados, respectivamente, como aqueles executados abaixo e acima de 200 ms considerando o início do movimento do chutador e o início do movimento do goleiro. Os resultados mostraram que o goleiro executou comportamentos antecipatórios predominantemente quando (i) ocorreram gols, (ii) os chutes foram executados das zonas central e de ataque, (iii) de distâncias entre 5,97 a 7,84 metros. Nestas condições, os comportamentos antecipatórios do goleiro implicaram em performances ineficazes.

The differentiated effect of the task complexity on retention and transfer of stroke survivors.

The aim of this study was to investigate the effects of task complexity on the motor learning of by stroke survivors. Participants (N = 24) performed 150 trials of a simple or complex balance task during three acquisition days. Level of complexity was determined by the number of sequential movements. Outcomes were recorded on pretest, posttest, retention and transfer test. Data were analyzed by considering measures of performance score and movement time. Results showed that only the low complexity group improved the performance from the pretest to posttest and maintained it in the retention test. Performance worsened in both groups from retention to transfer test. The main conclusions were: (i) complex task did not allow learning; (ii) stroke survivors were able to learn a simple task in terms of retention, but not of transfer.

Motor learning in post stroke subjects: the effects of practice conditions on the temporal synchronization

Abstract AIMS The aim of this study was to investigate the effects of practice schedule on the motor learning of a synchronization timing task in post-stroke subjects. Subjects and METHODS Seventeen post-stroke individuals were assigned to the experimental group and for the control group were selected seventeen healthy individuals. At the acquisition phase, all participants performed 30 trials of a coincident timing task. Nine individuals from each group practiced constantly and eight from each group practiced randomly, with speed changes in the task. Subsequent phases included: 1) immediate transfer test and 2) long term transfer test after 3 days. Data were analyzed in relation to absolute, variable, and constant errors to assess the performance concerning accuracy, consistence, and direction of responses, respectively. RESULTS All groups increased their accuracy through the practice and were able to adapt it in different speeds. The stroke subjects were more variable in their motor responses. There was no effect of the practice schedule on motor learning, regardless the presence or absence of the neurologic damage. CONCLUSION Post stroke individuals were able to learn a synchronizing task and the capacity of adapt their performance after speed perturbation was preserved. There was no effect of the practice schedule on motor learning.

Effects of virtual reality for stroke individuals based on the International Classification of Functioning and Health: a systematic review.

OBJECTIVE: This review determines the effects of virtual reality interventions for stroke subjects based on the International Classification of Functioning, Disability,and Health (ICF) framework. Virtual reality is a promising tool for therapy for stroke rehabilitation, but the effects of virtual reality interventions on post-stroke patients based on the specific ICF domains (Body Structures, Body Functions, Activity, and Participation) have not been investigated. METHOD: A systematic review was conducted, including trials with adults with a clinical diagnosis of a chronic, subacute, or acute stroke. Eligible trials had to include studies with an intervention protocol and follow-up, with a focus on upper limbs and/or lower limbs and/or balance. The Physiotherapy Evidence Database (PEDro) was used to assess the methodological quality of randomized controlled trials. Each trial was separated according to methodological quality into a high-quality trial (PEDro ≥ 6) and a low-quality trial (PEDro ≤ 6). Only high-quality trials were analyzed specifically based on the outcome of these trials. RESULTS: In total, 54 trials involving 1811 participants were included. Of the papers included and considered high quality, 14 trials evaluated areas of the Body Structures component, 20 trials of the Body Functions domain, 17 trials of the Activity component, and 8 trials of the Participation domain. In relation to ICF Part 2, four trials evaluated areas of the Personal Factors component and one trial evaluated domains of the Environmental Factors component. DISCUSSION: The effects of virtual reality on stroke rehabilitation based on the ICF framework are positive in Body Function and Body Structure. However, the results in the domains Activity and Participation are inconclusive. More high-quality clinical trials are needed to confirm the effectiveness of virtual reality in the domains of Activity and Participation.

Aprendizagem motora em crianças com paralisia cerebral / Motor learning in children with cerebral palsy

INTRODUÇÃO: a Paralisia Cerebral (PC) tem como característica causar alterações na postura e movimento que dificultam a realização de atividades funcionais. Diante das dificuldades motoras, a reabilitação torna-se essencial e tem como uma opção basear-se na aprendizagem motora. Porém, é importante a investigação do processo de aprendizagem motora em indivíduos com PC para viabilizar a organização de programas de tratamento mais efetivos. OBJETIVO: analisar o processo de aprendizagem motora em crianças com PC. MÉTODO: Para a realização deste trabalho utilizou-se um grupo experimental (GE) e um grupo controle (GC) ambos formados por 4 crianças pareadas em relação ao gênero (um do gênero feminino e três do gênero masculino) e idade (entre sete e doze anos). A tarefa consistia em realizar um caminho em um labirinto, no menor tempo possível. O trabalho consistiu de duas fases, sendo inicialmente a fase de aquisição (AQ) e depois as transferências (Imediata-TI; Curto Prazo-TC e Longo Prazo-TL). RESULTADO: Verificou-se que não houve diferença estatisticamente significante entre a AQ e as transferências avaliadas com os valores a seguir: TI (z = -1,83 e p = 0,07), TC (z = -1,83 e p = 0,07) e a TL [GE (z = -1,83 e p = 0,07) e GC (z = -1,46 e p = 0,14)]. CONCLUSÃO: No processo de aprendizagem da tarefa de labirinto, analisando-se os resultados entre as fases de AQ e Transferência não se observou diferença, ou seja, os indivíduos com PC mostraram capacidade de aprendizagem preservada por meio da adaptação da tarefa, fato este que ocorreu de forma equivalente aos indivíduos sem paralisia cerebral(AU)

Aprendizagem motora em crianças com paralisia cerebral / Motor learning in children with cerebral palsy

INTRODUÇÃO: a Paralisia Cerebral (PC) tem como característica causar alterações na postura e movimento que dificultam a realização de atividades funcionais. Diante das dificuldades motoras, a reabilitação torna-se essencial e tem como uma opção basear-se na aprendizagem motora. Porém, é importante a investigação do processo de aprendizagem motora em indivíduos com PC para viabilizar a organização de programas de tratamento mais efetivos. OBJETIVO: analisar o processo de aprendizagem motora em crianças com PC. MÉTODO: Para a realização deste trabalho utilizou-se um grupo experimental (GE) e um grupo controle (GC) ambos formados por 4 crianças pareadas em relação ao gênero (um do gênero feminino e três do gênero masculino) e idade (entre sete e doze anos). A tarefa consistia em realizar um caminho em um labirinto, no menor tempo possível. O trabalho consistiu de duas fases, sendo inicialmente a fase de aquisição (AQ) e depois as transferências (Imediata-TI; Curto Prazo-TC e Longo Prazo-TL). RESULTADO: Verificou-se que não houve diferença estatisticamente significante entre a AQ e as transferências avaliadas com os valores a seguir: TI (z = -1,83 e p = 0,07), TC (z = -1,83 e p = 0,07) e a TL [GE (z = -1,83 e p = 0,07) e GC (z = -1,46 e p = 0,14)]. CONCLUSÃO: No processo de aprendizagem da tarefa de labirinto, analisando-se os resultados entre as fases de AQ e Transferência não se observou diferença, ou seja, os indivíduos com PC mostraram capacidade de aprendizagem preservada por meio da adaptação da tarefa, fato este que ocorreu de forma equivalente aos indivíduos sem paralisia cerebral.(AU)

INTRODUCTION: cerebral palsy (CP) has the characteristic of causing changes in posture and movement that hamper the achievement of functional activities. In the face of motor disabilities, rehabilitation becomes essential and is an option based on motor learning. However, it is important to research the motor learning process in individuals with CP to make the organization of treatment programs more effective. OBJECTIVE: Analyse the motor learning in children with CP. METHOD: For the realization of this work, an experimental group (EG) and a control group (CG) was used, comprised of four children matched in relation to gender (one female and three masculine) and age (between seven and twelve years). The task was to conduct a path into a maze in the shortest time possible. The work consisted of two phases, being initially an acquisition phase (AQ) and then transfers (immediate-IM; short-term-ST and long-term-LT). RESULT: It was found that there was no statistical significance difference between AQ and transfers evaluated with the following values: IM (z= -1.83, p=0.07), ST (z= -1.83, p=0.07) and LT [EG (z= -1.83, p=0.07) and CG (z= -1.46, p=0.14)]. CONCLUSION: In the process of maze task learning, when analyzing the results between phases AQ and transfer, significant difference was not observed, which means that individuals with CP showed learning capacity through task adaptation equivalent to individuals without cerevral palsy.(AU)

Aprendizagem motora em crianças com paralisia cerebral / Motor learning in children with cerebral palsy

INTRODUÇÃO: A paralisia cerebral (PC) tem como característica causar alterações na postura e movimento que dificultam a realização de atividades funcionais. Diante das dificuldades motoras, a reabilitação torna-se essencial e tem como uma opção basear-se na aprendizagem motora. Porém, é importante a investigação do processo de aprendizagem motora em indivíduos com PC para viabilizar a organização de programas de tratamento mais efetivos. OBJETIVO: analisar o processo de aprendizagem motora em crianças com PC. MÉTODO: Para a realização deste trabalho utilizou-se um grupo experimental (GE) e um grupo controle (GC) ambos formados por 4 crianças pareadas em relação ao gênero (um do gênero feminino e três do gênero masculino) e idade (entre sete e doze anos). A tarefa consistia em realizar um caminho em um labirinto, no menor tempo possível. O trabalho consistiu de duas fases, sendo inicialmente a fase de aquisição (AQ) e depois as transferências (Imediata-TI; Curto Prazo-TC e Longo Prazo-TL). RESULTADO: Verificou-se que não houve diferença estatisticamente significante entre a AQ e as transferências avaliadas com os valores a seguir: TI (z = -1,83 e p = 0,07), TC (z = -1,83 e p = 0,07) e a TL [GE (z = -1,83 e p = 0,07) e GC (z = -1,46 e p = 0,14)]. CONCLUSÃO: No processo de aprendizagem da tarefa de labirinto, analisando-se os resultados entre as fases de AQ e Transferência não se observou diferença, ou seja, os indivíduos com PC mostraram capacidade de aprendizagem preservada por meio da adaptação da tarefa, fato este que ocorreu de forma equivalente aos indivíduos sem paralisia cerebral.

INTRODUCTION: Cerebral palsy (CP) has the characteristic of causing changes in posture and movement that hamper the achievement of functional activities. In the face of motor disabilities, rehabilitation becomes essential and is an option based on motor learning. However, it is important to research the motor learning process in individuals with CP to make the organization of treatment programs more effective. OBJECTIVE: Analyse the motor learning in children with CP. METHOD: For the realization of this work, an experimental group (EG) and a control group (CG) was used, comprised of four children matched in relation to gender (one female and three masculine) and age (between seven and twelve years). The task was to conduct a path into a maze in the shortest time possible. The work consisted of two phases, being initially an acquisition phase (AQ) and then transfers (immediate-IM; short-term-ST and long-term-LT). RESULT: It was found that there was no statistical significance difference between AQ and transfers evaluated with the following values: IM (z= -1.83, p=0.07), ST (z= -1.83, p=0.07) and LT [EG (z= -1.83, p=0.07) and CG (z= -1.46, p=0.14)]. CONCLUSION: In the process of maze task learning, when analyzing the results between phases AQ and transfer, significant difference was not observed, which means that individuals with CP showed learning capacity through task adaptation equivalent to individuals without cerevral palsy.