National Institute on Aging-Alzheimer's Association guidelines for the neuropathologic assessment of Alzheimer's disease: a practical approach.

We present a practical guide for the implementation of recently revised National Institute on Aging-Alzheimer's Association guidelines for the neuropathologic assessment of Alzheimer's disease (AD). Major revisions from previous consensus criteria are: (1) recognition that AD neuropathologic changes may occur in the apparent absence of cognitive impairment, (2) an "ABC" score for AD neuropathologic change that incorporates histopathologic assessments of amyloid ß deposits (A), staging of neurofibrillary tangles (B), and scoring of neuritic plaques (C), and (3) more detailed approaches for assessing commonly co-morbid conditions such as Lewy body disease, vascular brain injury, hippocampal sclerosis, and TAR DNA binding protein (TDP)-43 immunoreactive inclusions. Recommendations also are made for the minimum sampling of brain, preferred staining methods with acceptable alternatives, reporting of results, and clinico-pathologic correlations.

Impacto da fisioterapia na reabilitação do alcance e manipulação de indivíduos hemiparéticos, vítimas de acidente vascular encefálico: o que é evidência? / Impact of physical therapy on rehabilitation of reaching and manipulation in post stroke hemiparetic subjects: what’s the evidence?

O objetivo deste artigo é determinar as evidências da intervenção fisioterapêutica, na melhora da função de Alcance e Manipulação de pacientes hemiparéticos, vítimas de Acidente Vascular Encefálico. Metodologia: Uma pesquisa computadorizada foi conduzida nas bases de dados: Medline, Cochrane, PEDro e Pubmed. Estudos Clínicos Aleatorizados (ECA) assim como Estudo Clínico Controlado (ECC), foram incluídos neste estudo. Para a presente revisão, a fisioterapia foi classificada em 6 categorias de intervenção: 1) fisioterapia tradicional, 2) terapia de uso forçado, 3) treinamento de tarefa específica, 4) terapia com biofeedback, 5) terapia com estimulação elétrica funcional – FES, 6) uso de órteses. A qualidade metodológica dos Estudos Aleatorizados foi classificada com a escala PEDro. Resultados: Um total de 31 publicações foi utilizado neste estudo. A qualidade metodológica de todos os Estudos Clínicos Aleatórios (ECA) possuem uma média de 5 pontos na escala de 10 pontos PEDro (4-8 pontos). Para cada categoria de intervenção foram apresentados os resultados que caracterizam a síntese de melhores evidências. Observa-se melhores evidências científicas nos tratamentos com uso de biofeedback, terapia de uso forçado e treinamento de tarefa específica no que se refere à reabilitação centrada na função. Conclusão: A presente revisão vem corroborar com a prática fisioterapeutica baseada em evidências científicas.

The aim of this study was to establish the evidence of the physical therapy intervention on functional recovery and manipulation in hemiparetic post stroke patients. Methods: A computer based research was performed on the data bases: Medline, Cochrane, PEDro and Pubmed. Randomized Clinical Trials (RCT) and Controlled Clinical Trials (CCT) were included in this study. In this review, the physiotherapy was classified in 6 categories of intervention: 1) traditional physical therapy, 2) forced used therapy, 3) specific task training, 4) biofeedback therapy, 5) function electric stimulation therapy- FES, 6) use of orthesis. The methodological quality of the Randomized Studies was based on the PEDro scale. Results: A total of 31 publications were chosen to this study. The methodological quality average of the RCT was 5 points in the PEDro 10 points scale (4-8points). To each category of intervention, the results that better characterized the synthesis of the best evidences were presented. Better evidence is observed in treatment with Biofeedback, Forced Use Therapy and Specific Task Training. Conclusion: The current review corroborates with the practice evidence-based physical therapy.